MEDICARE: JOSEPH SUNGKWANG CHAE

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	101YP2500X	Professional Counselor	178.015066	IL

General Provider Information

NPI Number	:	1548760416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH SUNGKWANG CHAE

Provider Business Mailing Address
First Line	:	869 W BLACKHAWK ST APT 306
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-2638
Country	:	US
Telephone Number	:	773-412-8933
Fax Number	:

Provider Business Practice Location Address
First Line	:	869 W BLACKHAWK ST APT 306
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-2638
Country	:	US
Telephone Number	:	773-412-8933
Fax Number	:

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

Provider Enumeration Date	:	02/17/2018
Last Update Date	:	02/18/2026

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