Provider Demographics
NPI:1053426882
Name:CHUN, BYUNG KWAN (DC)
Entity type:Individual
Prefix:MR
First Name:BYUNG
Middle Name:KWAN
Last Name:CHUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N MILWAUKEE AVE
Mailing Address - Street 2:STE B
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-3071
Mailing Address - Country:US
Mailing Address - Phone:847-541-3456
Mailing Address - Fax:847-541-3656
Practice Address - Street 1:325 N MILWAUKEE AVE
Practice Address - Street 2:STE B
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-3071
Practice Address - Country:US
Practice Address - Phone:847-541-3456
Practice Address - Fax:847-541-3656
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635320OtherBLUE CROSS BLUE SHIELD
IL212979Medicare ID - Type Unspecified
IL01635320OtherBLUE CROSS BLUE SHIELD