Individual
MS. JUDY SUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
47 W POLK ST, SUITE G1, CHICAGO, IL 60605-2000
(312) 922-3011
(312) 922-5860
Mailing address
2525 S MICHIGAN AVE, ATT: MEDICAL STAFF OFFICE, CHICAGO, IL 60616-2315
(312) 567-7924
(312) 567-6189
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036114649
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBS OF IL
IL
05
—
036114649 / 01
—
IL
01
—
K22967
MEDICARE PTAN
IL
Enumeration date
12/12/2005
Last updated
07/05/2016
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