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Individual

MICHAEL FUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6975
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-6975

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.009445
IL
103TC1900X
Counseling Psychologist
3420-57
WI

Other

Enumeration date
03/03/2016
Last updated
12/07/2016
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