MEDICARE: DR. LO-KU CHIANG 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	207RN0300X	Nephrology Physician	036118582	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386842557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LO-KU CHIANG M.D.

Provider Business Mailing Address
First Line	:	210 S DESPLAINES ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60661-5500
Country	:	US
Telephone Number	:	312-654-2700
Fax Number	:	312-654-9930

Provider Business Practice Location Address
First Line	:	121 S WILKE RD STE 111
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1524
Country	:	US
Telephone Number	:	847-394-1843
Fax Number	:	847-394-1208

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	11/22/2024

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