Healthcare Provider Details

I. General information

NPI: 1669763884
Provider Name (Legal Business Name): YU-CHUN HUNG MSSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2011
Last Update Date: 04/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4822 N BROADWAY ST SECOND FLOOR
CHICAGO IL
60640-3604
US

IV. Provider business mailing address

601 LARAMIE AVE
GLENVIEW IL
60025-3453
US

V. Phone/Fax

Practice location:
  • Phone: 773-433-1200
  • Fax:
Mailing address:
  • Phone: 847-863-2330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.013712
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: