MEDICARE: DR. JIN WUNG HWANG DMD

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	1223P0300X	Periodontics	DS042301	PA

General Provider Information

NPI Number	:	1225690670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JIN WUNG HWANG DMD

Provider Business Mailing Address
First Line	:	2410 SAMPSON ST
Second Line	:
City	:	GREAT LAKES
State	:	IL
Zip	:	60088-2942
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2410 SAMPSON ST
Second Line	:
City	:	GREAT LAKES
State	:	IL
Zip	:	60088-2942
Country	:	US
Telephone Number	:	847-688-2469
Fax Number	:

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

Provider Enumeration Date	:	07/07/2019
Last Update Date	:	06/16/2026

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