MEDICARE: DR. DANIEL ING-HSU WU 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	207V00000X	Obstetrics & Gynecology Physician		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
2	01621679	OTHER	IL	BCBS OF IL

General Provider Information

NPI Number	:	1821074246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL ING-HSU WU M.D.

Provider Business Mailing Address
First Line	:	2154 S ARCHER AVE FL 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1514
Country	:	US
Telephone Number	:	312-528-0088
Fax Number	:	312-528-0080

Provider Business Practice Location Address
First Line	:	2154 S ARCHER AVE FL 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1514
Country	:	US
Telephone Number	:	312-528-0088
Fax Number	:	312-528-0080

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

Provider Enumeration Date	:	12/17/2005
Last Update Date	:	07/08/2007

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