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NPI Code Detail

MEDICARE: SUNG K CHANG MD

MEDICARE: SUNG K CHANG MD
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
12085R0001XRadiation Oncology Physician036.052586IL

General Provider Information

NPI Number : 1609853985
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNG K CHANG MD
Provider Business Mailing Address
First Line : 2520 ELISHA AVE
Second Line :
City : ZION
State : IL
Zip : 60099-2676
Country : US
Telephone Number : 847-872-4561
Fax Number :
Provider Business Practice Location Address
First Line : 2520 ELISHA AVE
Second Line :
City : ZION
State : IL
Zip : 60099-2676
Country : US
Telephone Number : 847-731-4184
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 12/12/2014

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