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NPI Code Detail

MEDICARE: MRS. YOUNG CHEON-KLESSIG FNP

MEDICARE:  MRS. YOUNG  CHEON-KLESSIG  FNP
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
1363LF0000XFamily Nurse PractitionerIL

General Provider Information

NPI Number : 1770619538
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. YOUNG CHEON-KLESSIG FNP
Provider Business Mailing Address
First Line : UPTOWN NHC
Second Line : 845 WEST WILSON AVE.
City : CHICAGO
State : IL
Zip : 60640-5704
Country : US
Telephone Number : 312-742-0834
Fax Number : 312-744-5023
Provider Business Practice Location Address
First Line : 845 W WILSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640-5704
Country : US
Telephone Number : 312-742-0834
Fax Number : 312-744-5023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. YOUNG CHEON-KLESSIG FNP” Practice Location

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