Individual
DR. RANDY JOHN JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 W LINCOLN ST, SUITE 106, BELLEVILLE, IL 62220-1901
(618) 235-1582
(618) 235-2473
Mailing address
PO BOX 354, SUITE 106, BELLEVILLE, IL 62222-0354
(618) 235-1582
(618) 235-2473
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036085990
IL
2084P0805X
Geriatric Psychiatry Physician
036085990
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085990
—
IL
Enumeration date
10/18/2006
Last updated
04/28/2016
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