| Chung M. Song, Md, Sc | |
|
6202 S Halsted St Chicago IL 60621-2029 | |
| (773) 651-2188 | |
| (773) 651-9655 |
| Full Name | Chung M. Song, Md, Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6202 S Halsted St, Chicago, Illinois |
| Authorized Official Name and Position | Chung M Song (PRESIDENT) |
| Authorized Official Contact | 8479489661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chung M. Song, Md, Sc 2910 Cherokee Ln Riverwoods IL 60015-1609 Ph: (847) 948-9661 | Chung M. Song, Md, Sc 6202 S Halsted St Chicago IL 60621-2029 Ph: (773) 651-2188 |
| NPI Number | 1730378423 |
|---|---|
| Provider Enumeration Date | 10/17/2007 |
| Last Update Date | 11/27/2007 |
| Medicare PECOS PAC ID | 6204886260 |
|---|---|
| Medicare Enrollment ID | O20050127000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730378423 | NPI | - | NPPES |
| 036068375 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 042.617778 (Illinois) | Primary |
| Provider Name | Chung M Song |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710914999 PECOS PAC ID: 9830149855 Enrollment ID: I20050128000431 |
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