MEDICARE: ILLINOIS MEDICAL CARE AND CONSULTING, LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1770840555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ILLINOIS MEDICAL CARE AND CONSULTING, LLC

Provider Business Mailing Address
First Line	:	2932 WHISPERING OAKS DR
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-6329
Country	:	US
Telephone Number	:	773-275-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 W ARGYLE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-3610
Country	:	US
Telephone Number	:	773-275-8300
Fax Number	:	773-275-8320

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. CHUNLIU ZHU
Credential	:	MD
Telephone Number	:	773-275-8300

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	04/18/2012

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