| Kwang P Chung Md Sc | |
|
903 Greenbrier Rd Earlville IL 60518-0607 | |
| (815) 246-6344 | |
| (815) 246-4711 |
| Full Name | Kwang P Chung Md Sc |
|---|---|
| Speciality | General Practice |
| Location | 903 Greenbrier Rd, Earlville, Illinois |
| Authorized Official Name and Position | Kwang P Chung (OWNER PRESIDENT) |
| Authorized Official Contact | 8152466344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwang P Chung Md Sc Po Box 607 903 Greenbrier Rd Earlville IL 60518-0607 Ph: (815) 246-6344 | Kwang P Chung Md Sc 903 Greenbrier Rd Earlville IL 60518-0607 Ph: (815) 246-6344 |
| NPI Number | 1073787941 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073787941 | NPI | - | NPPES |
| 036055582 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 036055582 (Illinois) | Primary |