Individual
DR. CHUNG KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 W SOUTH 4TH ST, STE C, RED BUD, IL 62278-1195
(618) 282-8700
(618) 282-8703
Mailing address
415 W SOUTH 4TH ST, STE C, RED BUD, IL 62278-1195
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036045245
IL
Other
Enumeration date
06/10/2005
Last updated
09/28/2010
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