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General NPI Number Information
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NPI Number | 1215484605
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Entity Type | Individual
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Provider Name | CHRISTOPHER CHUNG MD
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Gender | Male
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Dates
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Enumeration Date | 09/02/2016
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 1009 S WOOD ST
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City | CHICAGO
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State | IL
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Zip | 60612-3747
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Country | US
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Telephone | 312-996-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 1614 E CHEVY CHASE DR APT 6
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City | GLENDALE
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State | CA
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Zip | 91206-2856
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Country | US
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Telephone | 408-431-2857
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A189229
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036168736
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License Number State | IL
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