Provider Demographics
NPI:1992842801
Name:TSENG, TONY (MD)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:
Last Name:TSENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12710 N GEORGETOWNE RD
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:IL
Mailing Address - Zip Code:61525-9462
Mailing Address - Country:US
Mailing Address - Phone:206-390-3873
Mailing Address - Fax:
Practice Address - Street 1:10400 HALIGUS RD
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9553
Practice Address - Country:US
Practice Address - Phone:224-654-0000
Practice Address - Fax:224-654-0000
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036151342207L00000X
PAMD430589207L00000X
OK37480207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101865777Medicaid
PA108774Medicare PIN