Provider Demographics
NPI:1417968132
Name:CHUN, YONG CHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:YONG
Middle Name:CHUL
Last Name:CHUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 TORREY PINES PKWY
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062
Mailing Address - Country:US
Mailing Address - Phone:847-564-3787
Mailing Address - Fax:773-539-0251
Practice Address - Street 1:3755 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625
Practice Address - Country:US
Practice Address - Phone:773-539-5333
Practice Address - Fax:773-539-0251
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2012-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-053060207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036053060Medicaid
IL036053060Medicaid
700080Medicare ID - Type Unspecified