Provider Demographics
NPI:1932197316
Name:CHUNG, YOUNG (MD)
Entity Type:Individual
Prefix:MR
First Name:YOUNG
Middle Name:
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 1:901 CENTER ST
Mailing Address - Street 2:STE 305
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-2104
Mailing Address - Country:US
Mailing Address - Phone:847-695-6611
Mailing Address - Fax:847-695-8069
Practice Address - Street 1:901 CENTER ST
Practice Address - Street 2:STE 305
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-2104
Practice Address - Country:US
Practice Address - Phone:847-695-6611
Practice Address - Fax:847-695-8069
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21602371OtherBCBS
IL21602371OtherBCBS
988570Medicare ID - Type Unspecified