Organization
CHIA LUN CHUNG PSYD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIA LUN CHUNG PSYD (CLINICAL PSYCHOLOGIST)
(773) 255-1293
Entity
Organization
Contact information
Practice address
4753 N BROADWAY ST, SUITE 821, CHICAGO, IL 60640-5266
(773) 255-1293
Mailing address
4753 N BROADWAY ST, SUITE 821, CHICAGO, IL 60640-5266
(773) 255-1293
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-006862
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528077815
NPPES
IL
Enumeration date
09/07/2007
Last updated
06/24/2009
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