Doctor Name: | DR. WEN GENN CHU |
NPI Number: | 1053755678 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036051098 |
Business Practice Address: | 15620 Narcissus Ln Orland Park, IL - 604625016 |
Business Phone Number: | 7084295997 |
Business Fax Number: | |
Mailing Address: | 15620 Narcissus Ln, ORLAND PARK |
State: | IL |
Postal Code: | 604625016 |
Phone Number: | 7084295997 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2013 |
NPI Last Update Date: | 04/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036051098 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |