Individual provider Active NPI

Jennifer Chung, APRN, CNP

  • Nurse Practitioner
  • Wheaton, IL
National Provider Identifier
1902558075
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209021072 Issued in IL
Practice address
1800 N Main St Ste 100
Wheaton, IL 60187-3112
Phone
(630) 653-4240
Fax
(630) 315-6557
NPI assigned
Jan 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209.021072 IL
Nurse Practitioner 363L00000X 209021072 IL Primary

Addresses

Primary practice location

1800 N Main St Ste 100
Wheaton, IL 60187-3112

Mailing address

1800 N Main St Ste 100
Wheaton, IL 60187-3112
Phone (630) 653-4240

Other practice location 1

345 Ashland Ave
River Forest, IL 60305-2109
Phone (708) 488-0072

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130001977 IL Practitioner - Nurse Practitioner 0345698361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209021072ILMDNurse Practitioner
209.021072ILMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Dec 1, 2023 Accepting new patients
Elizabeth R Nye M.D. ,S.C. CurrentSince Feb 18, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Dec 1, 2023 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

285 Roosevelt Rd
Glen Ellyn, IL 60137
Phone (630) 469-0045

636 Raymond Dr
Ste 303
Naperville, IL 60563
Phone (630) 357-6540

345 Ashland Ave
River Forest, IL 60305
Phone (312) 670-2530

1800 N Main St
Ste 100
Wheaton, IL 60187

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1902558075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N MAIN ST STE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873112",
            "telephone_number": "630-653-4240",
            "fax_number": "630-315-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N MAIN ST STE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873112",
            "telephone_number": "630-653-4240",
            "fax_number": "630-315-6557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Ashland Ave",
            "address_purpose": "LOCATION",
            "city": "River Forest",
            "state": "IL",
            "postal_code": "603052109",
            "country_code": "US",
            "telephone_number": "708-488-0072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JENNIFER",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209.021072",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209021072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.