Provider Demographics
NPI:1508657289
Name:KALONGO, EDDY
Entity type:Individual
Prefix:
First Name:EDDY
Middle Name:
Last Name:KALONGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10304 MONARCH RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-6555
Mailing Address - Country:US
Mailing Address - Phone:262-225-3044
Mailing Address - Fax:
Practice Address - Street 1:10304 MONARCH RD
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-6555
Practice Address - Country:US
Practice Address - Phone:262-225-3044
Practice Address - Fax:262-225-3044
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter