Individual ProviderHung DuongFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address965 Lake St, Oak Park, IL 60301(708) 386-3000PECOS EnrollmentBased on the most recent information from CMS, provider Hung Duong is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1245257781Provider TypeIndividualFull NameDuong, HungCredentialMDGenderMaleSole ProprietorNoEnumeration Date7/17/2006Last Updated5/15/2018Contact InformationPractice LocationPractice Address965 Lake St, Oak Park, IL 60301Phone(708) 386-3000FaxUnlisted FaxMailing LocationMailing Address11967 Caneridge Pl, San Diego, CA 92128-5239PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense036-115012IllinoisCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense036115012IllinoisProvider IdentifiersIDDescriptionIssuerID036-115012DescriptionOtherIssuerSTATE LICENSEIllinoisID036115012DescriptionMedicaidIssuerUnlistedIllinois