Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209.016478 | IL |
NPI | 1003325267 |
---|---|
Provider Name | Catherine L Chung |
First Address | Naperville, IL 60564-9470 |
Second Address | Chicago, IL 60616-1514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2017 |
Last Update Date | 20/09/2017 |