Provider Demographics
NPI:1215917653
Name:SUN, TUNG-HSI JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:TUNG-HSI
Middle Name:JOHN
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:SUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:101 SOUTH BROADWAY STREET
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-4276
Mailing Address - Country:US
Mailing Address - Phone:630-896-7900
Mailing Address - Fax:630-801-7809
Practice Address - Street 1:101 SOUTH BROADWAY ST.
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-4276
Practice Address - Country:US
Practice Address - Phone:630-896-7900
Practice Address - Fax:630-801-7809
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036092634207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG43372Medicare UPIN