NPIMap

Organization Active NPI

Kwang P Chung MD SC

  • General Practice Physician
  • Earlville, IL
National Provider Identifier
1073787941
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036055582 Issued in IL
Legal business name
KWANG P CHUNG MD SC
Practice address
903 Greenbrier Rd
Earlville, IL 60518-0607
Phone
(815) 246-6344
Fax
(815) 246-4711
NPI assigned
Apr 22, 2008
Last updated
Apr 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kwang P Chung, MDNPI 1053371393
Title
Owner President
Phone
(815) 246-6344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 036055582 IL Primary

Addresses

Primary practice location

903 Greenbrier Rd
Earlville, IL 60518-0607

Mailing address

PO Box 607
903 Greenbrier Rd
Earlville, IL 60518-0607
Phone (815) 246-6344

National Provider Directory

National Provider Directory

Locations

903 Green Brier Rd
Earlville, IL 60518
Phone (815) 246-6344

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1073787941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "address_2": "903 GREENBRIER RD",
            "city": "EARLVILLE",
            "state": "IL",
            "postal_code": "605180607",
            "telephone_number": "815-246-6344",
            "fax_number": "815-246-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 GREENBRIER RD",
            "city": "EARLVILLE",
            "state": "IL",
            "postal_code": "605180607",
            "telephone_number": "815-246-6344",
            "fax_number": "815-246-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWANG P CHUNG MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "KWANG",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "815-246-6344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "036055582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Earlville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.