Organization
CHUNG M. SONG, MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUNG M SONG M.D. (PRESIDENT)
(847) 948-9661
Entity
Organization
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
(847) 948-9661
(773) 651-9655
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
042.617778
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036068375
—
IL
Enumeration date
10/17/2007
Last updated
11/27/2007
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