MEDICARE: KUN PENG 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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	036-143706	IL
2	207L00000X	Anesthesiology Physician	036143706	IL

General Provider Information

NPI Number	:	1790985349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KUN PENG MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE STE 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 SPALDING DR STE 308
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540
Country	:	US
Telephone Number	:	630-527-7730
Fax Number	:	630-527-7732

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

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	04/30/2026

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Directions to “ KUN PENG MD” Practice Location

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