Provider Demographics
NPI:1467402412
Name:CHUNG, NEUNGJA (PHD, MSOM)
Entity Type:Individual
Prefix:
First Name:NEUNGJA
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:PHD, MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 CHIPPEWA DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1385
Mailing Address - Country:US
Mailing Address - Phone:630-355-8446
Mailing Address - Fax:
Practice Address - Street 1:MENDOTA COMMUNITY HOSPITAL
Practice Address - Street 2:1315 MEMORIAL DRIVE
Practice Address - City:MENDOTA
Practice Address - State:IL
Practice Address - Zip Code:61342
Practice Address - Country:US
Practice Address - Phone:815-713-0468
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist