Organization
KWANG P CHUNG MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KWANG P CHUNG MD (OWNER PRESIDENT)
(815) 246-6344
Entity
Organization
Contact information
Practice address
903 GREENBRIER RD, EARLVILLE, IL 60518-0607
(815) 246-6344
(815) 246-4711
Mailing address
PO BOX 607, 903 GREENBRIER RD, EARLVILLE, IL 60518-0607
(815) 246-6344
(815) 246-4711
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036055582
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055582
—
IL
Enumeration date
04/22/2008
Last updated
04/22/2008
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