Individual provider Active NPI

Sung A Cheon, M.D.

  • Psychiatry Physician
  • Waukegan, IL
National Provider Identifier
1104838440
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036057505 Issued in IL
Practice address
2400 Belvidere Rd
Waukegan, IL 60085-6165
Phone
(847) 377-8779
Fax
(847) 984-5619
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 036057505 IL
Psychiatry Physician 2084P0800X 036057505 IL Primary

Addresses

Primary practice location

2400 Belvidere Rd
Waukegan, IL 60085-6165

Mailing address

761 Coventry Dr
Lake Forest, IL 60045-2785
Phone (847) 615-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180104000686 IL Practitioner - Psychiatry 5294973152 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036057505ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake Current Accepting new patients
County of Lake CurrentSince Jan 22, 2018 Accepting new patients
County of Lake CurrentSince Jan 22, 2018 Accepting new patients

Locations

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

Interoperability endpoints

  • Direct secure messaging: sung.cheon.p1@direct.lakecountyil.nextgenshare.com
  • Direct secure messaging: sung.cheon.1@13826.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1104838440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 COVENTRY DR",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452785",
            "telephone_number": "847-615-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BELVIDERE RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856165",
            "telephone_number": "847-377-8779",
            "fax_number": "847-984-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEON",
        "first_name": "SUNG",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "IL",
            "license": "036057505",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036057505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.