Provider Demographics
NPI:1194730267
Name:HUNG, MING LONG (MD)
Entity type:Individual
Prefix:DR
First Name:MING
Middle Name:LONG
Last Name:HUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:920 CURTISS ST UNIT 247
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5916
Mailing Address - Country:US
Mailing Address - Phone:815-741-2201
Mailing Address - Fax:888-741-7648
Practice Address - Street 1:3217 VENARD RD
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1108
Practice Address - Country:US
Practice Address - Phone:815-741-2201
Practice Address - Fax:888-741-7648
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093275208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932105OtherBC/ BS
IL036093275Medicaid
IL09932105OtherBC/ BS
IL036093275Medicaid