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Organization

MIKYUNG YUN OD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIKYUNG BAKER (PRESIDENT)
(630) 606-1618
Entity
Organization

Contact information

Practice address
150 SMITH RD, ST CHARLES, IL 60174-5203
(630) 513-9566
(630) 513-9786
Mailing address
150 SMITH RD, ST CHARLES, IL 60174-5203

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009764
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046-009764
IL
Enumeration date
03/03/2010
Last updated
03/11/2011
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