Provider Demographics
NPI:1528260940
Name:ONG, JASON C (PHD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:C
Last Name:ONG
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:1653 W CONGRESS PKWY
Mailing Address - Street 2:RUSH UNIVERSITY MEDICAL CENTER
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3833
Mailing Address - Country:US
Mailing Address - Phone:312-942-5440
Mailing Address - Fax:312-942-8961
Practice Address - Street 1:1653 W CONGRESS PKWY
Practice Address - Street 2:RUSH UNIVERSITY MEDICAL CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3833
Practice Address - Country:US
Practice Address - Phone:312-942-5440
Practice Address - Fax:312-942-8961
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 21461103TC0700X
IL071007474103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical