Healthcare Provider Details

I. General information

NPI: 1578406484
Provider Name (Legal Business Name): YUNSEO JEONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 SOUTH WOOD STREET UI HEALTH, GRADUATE MEDICAL EDUCA SUITE 100, MC 675
CHICAGO IL
60612
US

IV. Provider business mailing address

820 SOUTH WOOD STREET UI HEALTH, GRADUATE MEDICAL EDUCA SUITE 100, MC 675
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-2933
  • Fax:
Mailing address:
  • Phone: 312-996-2933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number125087918
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: