MEDICARE: KYUNGEUN JUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1215736400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYUNGEUN JUNG

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 OCOEE ST N
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-5382
Country	:	US
Telephone Number	:	423-559-1537
Fax Number	:	423-559-1539

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	03/14/2025

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Directions to “ KYUNGEUN JUNG ” Practice Location

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