Basic Information
Provider Information
NPI: 1336474014
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHANG
FirstName: JUNHUA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 211 S 3RD ST
Address2:  
City: BELLEVILLE
State: IL
PostalCode: 622201915
CountryCode: US
TelephoneNumber: 6182342120
FaxNumber: 6186415810
Practice Location
Address1: 211 S 3RD ST
Address2:  
City: BELLEVILLE
State: IL
PostalCode: 622201915
CountryCode: US
TelephoneNumber: 6182342120
FaxNumber: 6186415810
Other Information
ProviderEnumerationDate: 10/13/2009
LastUpdateDate: 02/11/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X036134459ILY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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