Healthcare Provider Details

I. General information

NPI: 1942116330
Provider Name (Legal Business Name): CAPSTONE UROLOGY OF ILLINOIS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 PROGRESS BLVD
PERU IL
61354-1124
US

IV. Provider business mailing address

4040 PROGRESS BLVD
PERU IL
61354-1124
US

V. Phone/Fax

Practice location:
  • Phone: 815-664-5367
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVE Y CHUNG
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 815-343-2222