Provider Demographics
NPI:1396966362
Name:IDEAL FAMILY HEALTH CENTER P.C.
Entity type:Organization
Organization Name:IDEAL FAMILY HEALTH CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANG
Authorized Official - Middle Name:RUNG
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-357-0636
Mailing Address - Street 1:2010 S ARLINGTON HEIGHTS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4100
Mailing Address - Country:US
Mailing Address - Phone:847-357-0636
Mailing Address - Fax:847-357-0637
Practice Address - Street 1:55 W GOLF RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3905
Practice Address - Country:US
Practice Address - Phone:847-357-0636
Practice Address - Fax:847-357-0637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1457633042171100000X
IL038009272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632781OtherBCBS
IL01632781OtherBCBS