Individual provider Active NPI

Caroline Marie Jung, L.AC., MSOM

  • Public Health & General Preventive Medicine Physician
  • Chicago, IL
National Provider Identifier
1457776361
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
198.000638 Issued in IL
Practice address
1817 W Berwyn Ave # 3
Chicago, IL 60640-1005
Phone
(773) 497-4949
NPI assigned
Feb 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 198.000638 IL Primary

Addresses

Primary practice location

1817 W Berwyn Ave # 3
Chicago, IL 60640-1005

Mailing address

1817 W Berwyn Ave # 3
Chicago, IL 60640-1005
Phone (773) 497-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
198.000638ILMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1457776361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 W BERWYN AVE # 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401005",
            "telephone_number": "773-497-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 W BERWYN AVE # 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401005",
            "telephone_number": "773-497-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "CAROLINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "L.AC., MSOM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-28",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "IL",
            "license": "198.000638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.