Organization
YOUNG JOUGH, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOUNG JOUGH M.D. (PRESIDENT)
(773) 967-5221
Entity
Organization
Contact information
Practice address
2320 E 93RD ST, CHICAGO, IL 60617-3983
(773) 967-5221
(773) 967-5972
Mailing address
PO BOX 388320, CHICAGO, IL 60638-8320
(773) 767-8283
(773) 767-8320
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
036051666
IL
283X00000X
Rehabilitation Hospital
Primary
036051666
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002201149
BLUE SHIELD
IL
05
—
036051666
—
IL
Enumeration date
05/25/2007
Last updated
08/27/2009
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