Individual
CHUNG SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6202 S HALSTED ST, CHICAGO, IL 60621-2029
(773) 651-2188
(773) 651-9655
Mailing address
2910 CHEROKEE LN, RIVERWOODS, IL 60015-1609
(773) 651-2188
(773) 651-9655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036068375
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036068375
—
IL
Enumeration date
06/26/2006
Last updated
01/29/2008
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