Provider Demographics
NPI:1952986168
Name:JEON, CAROLYN HYOJIN (AUD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:HYOJIN
Last Name:JEON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 HUNTERS POND RUN APT 31
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-2674
Mailing Address - Country:US
Mailing Address - Phone:773-577-7509
Mailing Address - Fax:
Practice Address - Street 1:455 W COURT ST STE 400
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3695
Practice Address - Country:US
Practice Address - Phone:815-937-8744
Practice Address - Fax:815-937-3528
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001785231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist