person
Jesse Kong, MMS,PA-C
Surgical Physician Assistant in Downers Grove, Illinois
NPI 1396879672

Jesse Kong is a Surgical Physician Assistant based in Chicago, IL and is specialized in Surgical. Jesse Kong practices in Downers Grove, IL and has the professional credentials of MMS,PA-C. The NPI Number for Jesse Kong is 1396879672 and holds a License No. 085-002627 (Illinois).

The current practice location address for Jesse Kong is 3551 Highland Ave Ste 200A, Downers Grove, IL and can be reached out via phone at 844-376-3876 and via fax at 630-929-0633.

Location: 3551 Highland Ave Ste 200A, Downers Grove, IL, 60673-1293
person
Provider Profile Details
NPI Number
1396879672
Provider Name
Jesse Kong
Credential
MMS,PA-C
Provider Entity Type
Individual
Gender
Male
Address
3551 Highland Ave Ste 200A, Downers Grove, IL, 60673-1293
Phone Number
844-376-3876
Fax Number
630-929-0633
Provider Enumeration Date
03/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
206147 01 IL MEDICARE PTAN (GROUP)
206147256 01 IL MEDICARE PTAN (INDIVIDUAL)
institution
Provider Business Practice Location Address Details
Address
3551 Highland Ave Ste 200A
City
State
Zip
60515-2100
Phone Number
844-376-3876
Fax Number
630-929-0633
person
Provider Business Mailing Address Details
Address
3551 Highland Ave Ste 200A
City
State
Zip
60515-2100
Phone Number
844-376-3876
Fax Number
630-929-0633
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
085-002627 (Illinois)
Definition
Definition to come...
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