Active NPI
Gina Chung
- Medical Physician Assistant
- Chicago, IL
National Provider Identifier
1629445242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 085.005518
- Practice address
- 2800 S California Ave
Chicago, IL 60608-5107 - Phone
- (773) 674-7488
- NPI assigned
- Aug 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085.005518 | IL | Primary |
Addresses
Primary practice location
2800 S California Ave
Chicago, IL 60608-5107
Mailing address
404 W Parkside Dr
Palatine, IL 60067-7380
Phone (847) 222-3906
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.005518 | IL | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1629445242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 W PARKSIDE DR",
"city": "PALATINE",
"state": "IL",
"postal_code": "600677380",
"telephone_number": "847-222-3906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 S CALIFORNIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606085107",
"telephone_number": "773-674-7488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "GINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-31",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085.005518",
"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 Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.