MEDICARE: JAE HEON JUNG

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1154216588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAE HEON JUNG

Provider Business Mailing Address
First Line	:	2400 W VILLARD AVENUE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 N LAKE DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211
Country	:	US
Telephone Number	:	414-527-8415
Fax Number	:

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

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	03/09/2026

Similar Medicare Providers

1003847237 — IRINA KOSTOVA DIMITROVA M.D.
Practice Location Address:

2350 N LAKE DR
MILWAUKEE, WI
53211-4528

Practice Phone: 414-585-1949
Practice Fax:

1992650378 — MARK EBERHAGE, PHD LLC
Practice Location Address:

1532 E BELLEVIEW PL
MILWAUKEE, WI
53211-3956

Practice Phone: 414-293-2733
Practice Fax:

1760338628 — RACHEL OBERTIN
Practice Location Address:

2301 N LAKE DR
MILWAUKEE, WI
53211

Practice Phone: 414-585-1200
Practice Fax:

1912216219 — LIGHTHOUSE CLINIC, LLC
Practice Location Address:

2524 E WEBSTER PL , SUITE 203
MILWAUKEE, WI
53211-4256

Practice Phone: 414-964-9200
Practice Fax: 414-964-4816

1275536625 — CYNTHIA FESTGE RN -ANP
Practice Location Address:

3351 N DOWNER AVE
MILWAUKEE, WI
53211-2954

Practice Phone: 414-229-4716
Practice Fax:

1881698496 — JONATHAN A ZLABEK MD
Practice Location Address:

2301 N LAKE DR
MILWAUKEE, WI
53211-4508

Practice Phone: 608-738-6827
Practice Fax:

Directions to “ JAE HEON JUNG ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.