Michael Fung, PhD
Psychologist, Clinical in Chicago, IL. Individual provider (NPI-1).
NPI number1003276957
StatusActive
Last updated in NPPESDec 7, 2016
Details
- NPI
- 1003276957
- Entity type
- Individual (NPI-1)
- Name
- Michael Fung
- Credential
- PhD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 3, 2016
- Last updated
- Dec 7, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 071.009445 | IL | Yes |
| 103TC1900X | Psychologist, Counseling | 3420-57 | WI |
Practice location
820 S Damen AveChicago, IL 60612-3728
Phone 312-569-6975
Mailing address
820 S Damen AveChicago, IL 60612-3728
Phone 312-569-6975
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