Basic Information
| Provider Information | |||||||||
| NPI: | 1518046499 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHUN | ||||||||
| FirstName: | YOON | ||||||||
| MiddleName: | WOOK | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 22487 | ||||||||
| Address2: | |||||||||
| City: | GREEN BAY | ||||||||
| State: | WI | ||||||||
| PostalCode: | 543052487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9204457222 | ||||||||
| FaxNumber: | 9204457289 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 S VANBUREN ST | ||||||||
| Address2: | |||||||||
| City: | GREEN BAY | ||||||||
| State: | WI | ||||||||
| PostalCode: | 54301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9204333420 | ||||||||
| FaxNumber: | 9203386859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2006 | ||||||||
| LastUpdateDate: | 12/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 43350020 | WI | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VF0040X | 43350-20 | WI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
ID Information
| ID | Type | State | Issuer | Description | 34089900 | 05 | WI | MEDICAID | 9004542 | 01 | BOARD CERTIFICATION FEMALE PELVIC MEDICINE AND RECONSTRUCTION | OTHER |