Provider Demographics
NPI:1598458481
Name:CHUNG, ALBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:M
Last Name:CHUNG
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 1:301 N 8TH STREET, ROOM 3A158
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62701
Mailing Address - Country:US
Mailing Address - Phone:217-545-3134
Mailing Address - Fax:
Practice Address - Street 1:301 N 8TH ST STE 3A158
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62701-1085
Practice Address - Country:US
Practice Address - Phone:217-545-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125081555207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology