Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | IL |
NPI | 1033240411 |
---|---|
Provider Name | Dr. Gene Lee Chang |
First Address | Dyer, IN 46311-1294 |
Second Address | Munster, IN 46321-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |