Individual provider Active NPI

Daniel Yongchul Jung

  • Massage Therapist
  • Vernon Hills, IL
National Provider Identifier
1982278545
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.022133 Issued in IL
Practice address
1 Birmingham PL
Vernon Hills, IL 60061-2103
Phone
(847) 596-0057
NPI assigned
May 18, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227.022133 IL Primary

Addresses

Primary practice location

1 Birmingham PL
Vernon Hills, IL 60061-2103

Mailing address

1 Birmingham PL
Vernon Hills, IL 60061-2103

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
227.022133ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1982278545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BIRMINGHAM PL",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600612103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BIRMINGHAM PL",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600612103",
            "telephone_number": "847-596-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "DANIEL",
        "middle_name": "YONGCHUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.022133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.