Youngtak CHI, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.029649 Issued in IL

Practice address

141 E Pershing Rd
Decatur, IL 62526-3213

Phone

(888) 988-4066

NPI assigned

Sep 27, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1154758712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD",
            "address_2": "610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734144",
            "telephone_number": "888-988-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E PERSHING RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263213",
            "telephone_number": "888-988-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHI",
        "first_name": "YOUNGTAK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.029649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles R. Potter, M.D., L.L.C.
• Debra G. Charveron, LCPC
• Lindsay Chassay, LPC
• Lynette Chausse
• Sundararaj R Cherala, MD
• Mary T Chierek, CRNA
• Madana M Chilakuri
• Shalini Chiravuri
• Suren Jenny Chiu, LDN
• Pamela Lou Chmielewski, CCC-SLP/L

• General Practice Dentistry in Decatur, IL
• Providers in Decatur, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.