MEDICARE: DR. CHAO-CHUNG HSU D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1285794933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAO-CHUNG HSU D.M.D.

Provider Business Mailing Address
First Line	:	1855 GOLDEN POND LN
Second Line	:
City	:	WHEATON
State	:	IL
Zip	:	60187-8083
Country	:	US
Telephone Number	:	847-577-0455
Fax Number	:	847-577-0455

Provider Business Practice Location Address
First Line	:	208 N DUNTON AVE STE A
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-5958
Country	:	US
Telephone Number	:	847-577-0455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/08/2007

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