Healthcare Provider Details

I. General information

NPI: 1679969737
Provider Name (Legal Business Name): VICKI ZHU JUN BING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST
CHICAGO IL
60611
US

IV. Provider business mailing address

1616 E 56TH ST UNIT 904
CHICAGO IL
60637-2706
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-0061
  • Fax:
Mailing address:
  • Phone: 203-506-6250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036.149167
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: