Provider Demographics
NPI:1699801175
Name:YU, CHANG JUN (DC, RPT)
Entity type:Individual
Prefix:
First Name:CHANG
Middle Name:JUN
Last Name:YU
Suffix:
Gender:M
Credentials:DC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 B EAST GOLF RD.
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005
Mailing Address - Country:US
Mailing Address - Phone:847-734-9303
Mailing Address - Fax:847-734-9304
Practice Address - Street 1:15 B EAST GOLF RD.
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005
Practice Address - Country:US
Practice Address - Phone:847-734-9303
Practice Address - Fax:847-734-9304
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL205071Medicare PIN
ILL95434Medicare PIN