Provider Demographics
NPI:1871884080
Name:CHUNG, HEAIN (LCSW)
Entity type:Individual
Prefix:
First Name:HEAIN
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 N KENMORE AVE
Mailing Address - Street 2:APT# 3S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4954
Mailing Address - Country:US
Mailing Address - Phone:412-216-8195
Mailing Address - Fax:
Practice Address - Street 1:2700 PATRIOT BLVD
Practice Address - Street 2:250
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8021
Practice Address - Country:US
Practice Address - Phone:312-756-0468
Practice Address - Fax:847-324-3299
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490168321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical