| Yong Chul Chun, M.d., S.c. | |
|
3755 W Lawrence Ave Chicago IL 60625-5712 | |
| (773) 539-5333 | |
| (773) 539-0251 |
| Full Name | Yong Chul Chun, M.d., S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3755 W Lawrence Ave, Chicago, Illinois |
| Authorized Official Name and Position | Yong Chul Chun (PRESIDENT) |
| Authorized Official Contact | 7735395333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yong Chul Chun, M.d., S.c. 3703 Torrey Pines Pkwy Northbrook IL 60062-3129 Ph: (773) 539-5333 | Yong Chul Chun, M.d., S.c. 3755 W Lawrence Ave Chicago IL 60625-5712 Ph: (773) 539-5333 |
| NPI Number | 1851608764 |
|---|---|
| Provider Enumeration Date | 09/13/2010 |
| Last Update Date | 09/13/2010 |
| Medicare PECOS PAC ID | 8527250075 |
|---|---|
| Medicare Enrollment ID | O20101004000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851608764 | NPI | - | NPPES |
| 036053060 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036053060 (Illinois) | Primary |
| Provider Name | Yong C Chun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417968132 PECOS PAC ID: 5799977245 Enrollment ID: I20101004000250 |
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