Maxwell Chung

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

715 Lake St Ste 720
Oak Park, IL 60301-1416

Phone

(773) 312-3612

NPI assigned

Jul 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1730815101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 CEDAR AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600354141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LAKE ST STE 720",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011416",
            "telephone_number": "773-312-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MAXWELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-28",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald M Cholewa, APRN
• Maria Chon, DPM
• Lisa M Chorzempa-Schainis, M.D.
• Cynthia Chow, AUD, PHD
• Christine Carpenter PSYD Inc
• Michelle Chung, DPT
• Paula Ciccarone, PH.D.
• Richard J Cicchetti, LCPC
• Kimberly Cimino, LMFT
• Cimpar at Home, LLC

• Mental Health Counselor in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.