Provider Demographics
NPI:1811150964
Name:JOHN P. HUNG, M.D.,S.C.
Entity type:Organization
Organization Name:JOHN P. HUNG, M.D.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:MERTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-932-1516
Mailing Address - Street 1:19 HERITAGE PLZ
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1369
Mailing Address - Country:US
Mailing Address - Phone:815-932-1516
Mailing Address - Fax:815-932-9412
Practice Address - Street 1:19 HERITAGE PLZ
Practice Address - Street 2:SUITE 210
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1369
Practice Address - Country:US
Practice Address - Phone:815-932-1516
Practice Address - Fax:815-932-9412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036052305207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43221Medicare UPIN