Provider Demographics
NPI:1750624664
Name:CHENG, VIRGINIA PEARSON (MD)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:PEARSON
Last Name:CHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:ELAINE
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4525 N RAVENSWOOD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5201
Mailing Address - Country:US
Mailing Address - Phone:312-878-4520
Mailing Address - Fax:708-575-8311
Practice Address - Street 1:4525 N RAVENSWOOD AVE STE 201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5201
Practice Address - Country:US
Practice Address - Phone:312-878-4520
Practice Address - Fax:708-575-8311
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4602602084P0800X, 2084P0800X
IL036.1463182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry