Most Relevant Information
Provider Data
| NPI Number: | 1003505884 |
| Provider Name: | TINA KANG |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209.024100 |
Most Important Dates
| Enumeration Date: | 05/05/2023 |
| Last Updated: | 05/05/2023 |
Provider Practice Location
1525 S SANGAMON ST UNIT 516
CHICAGO
IL
606082240
Practice Location Phone/Fax
| Phone: | 8472933840 |
| Fax: |
Provider Mailing Location
1525 S SANGAMON ST UNIT 516
CHICAGO
IL
606082240
Provider Mailing Phone/Fax
| Phone: | 8472933840 |
| Fax: |