Provider Demographics
NPI:1144244872
Name:CHUNG-HELLINGA, KRISTINA EUNJOO (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:EUNJOO
Last Name:CHUNG-HELLINGA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:EUNJOO
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:9 CANADA OAKS
Mailing Address - Street 2:
Mailing Address - City:COTO DE CAZA
Mailing Address - State:CA
Mailing Address - Zip Code:92679-4937
Mailing Address - Country:US
Mailing Address - Phone:312-330-3018
Mailing Address - Fax:
Practice Address - Street 1:4753 N BROADWAY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5266
Practice Address - Country:US
Practice Address - Phone:773-271-8284
Practice Address - Fax:773-271-9139
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001632897OtherBLUE CROSS BLUE SHIELD
IL364427599OtherAETNA
IL364427599OtherHUMANA
IL0001632897OtherBLUE CROSS BLUE SHIELD
IL364427599OtherAETNA