Most Relevant Information
Provider Data
NPI Number: | 1003390089 |
Provider Name: | JULIE CHANG MMS, PA-C |
Entity Type: | Individual |
Taxonomy Code: | 363A00000X |
Specialty: | Physician Assistant |
License Number: |
Most Important Dates
Enumeration Date: | 09/17/2018 |
Last Updated: | 11/13/2018 |
Provider Practice Location
3749 W 95TH ST
EVERGREEN PARK
IL
608052019
Practice Location Phone/Fax
Phone: | 7084226569 |
Fax: |
Provider Mailing Location
PO BOX 489
MATTESON
IL
604430489
Provider Mailing Phone/Fax
Phone: | 7088627674 |
Fax: |