Healthcare Provider Details

I. General information

NPI: 1023138815
Provider Name (Legal Business Name): SHARON CHYIHUEY FUNG MS, APN-CNS, CRRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHYI HUEY TZENG

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W HARRISON ST
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

1950 W. POLK ST. SUITE 427
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-3680
  • Fax: 312-864-9694
Mailing address:
  • Phone: 312-864-6000
  • Fax: 312-864-9734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number041-272928
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number041-272928
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code364SR0400X
TaxonomyRehabilitation Clinical Nurse Specialist
License Number209000986
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License Number041-272928
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: