Provider Demographics
NPI:1013109040
Name:JUNG, DONG KYU (DC)
Entity Type:Individual
Prefix:MR
First Name:DONG
Middle Name:KYU
Last Name:JUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:KYU
Other - Middle Name:
Other - Last Name:JUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:637 E GOLF RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005
Mailing Address - Country:US
Mailing Address - Phone:847-357-8770
Mailing Address - Fax:847-357-8771
Practice Address - Street 1:637 E GOLF RD
Practice Address - Street 2:SUITE 208
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005
Practice Address - Country:US
Practice Address - Phone:847-357-8770
Practice Address - Fax:847-357-8771
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38011007111N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program