Provider Demographics
NPI:1780809590
Name:CHUNG, PATRICIA Y (MS)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:Y
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 HEATHERDOWN WAY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1050
Mailing Address - Country:US
Mailing Address - Phone:847-663-2300
Mailing Address - Fax:847-663-2400
Practice Address - Street 1:710 HEATHERDOWN WAY
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1050
Practice Address - Country:US
Practice Address - Phone:847-663-2300
Practice Address - Fax:847-663-2400
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist