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General NPI Number Information
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NPI Number | 1225378912
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Entity Type | Individual
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Provider Name | DAVID SHIN CHANG D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/18/2013
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1000 N WESTMORELAND RD
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City | LAKE FOREST
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State | IL
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Zip | 60045-1658
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Country | US
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Telephone | 847-535-8281
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Fax | 847-535-8488
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Provider Business Mailing Address
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Address Line | 1000 N WESTMORELAND RD
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City | LAKE FOREST
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State | IL
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Zip | 60045-1658
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Country | US
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Telephone | 847-535-8281
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Fax | 847-535-8488
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | OP60765252
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036158277
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License Number State | IL
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