MEDICARE: JIHO CHUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		OR

General Provider Information

NPI Number	:	1104620186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIHO CHUNG

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	564 NE HIGHWAY 99W
Second Line	:
City	:	MCMINNVILLE
State	:	OR
Zip	:	97128-2707
Country	:	US
Telephone Number	:	503-472-0096
Fax Number	:	503-472-0097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2025
Last Update Date	:	04/01/2025

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Directions to “ JIHO CHUNG ” Practice Location

Language	Start Address	Practice Location

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