Provider Demographics
NPI:1932112208
Name:YUNG, CHEUK W (MD)
Entity Type:Individual
Prefix:DR
First Name:CHEUK
Middle Name:W
Last Name:YUNG
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 1:15300 WEST AVE
Mailing Address - Street 2:SUITE 120 SOUTH
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-4600
Mailing Address - Country:US
Mailing Address - Phone:708-460-7890
Mailing Address - Fax:708-460-5537
Practice Address - Street 1:15300 WEST AVE
Practice Address - Street 2:SUITE 120 SOUTH
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4600
Practice Address - Country:US
Practice Address - Phone:708-460-7890
Practice Address - Fax:708-460-7842
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036059742207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036059742Medicaid
ILL99553Medicare ID - Type Unspecified
D14504Medicare UPIN