Healthcare Provider Details

I. General information

NPI: 1417997057
Provider Name (Legal Business Name): KOK GEE CHUA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 N HIGHLAND AVE SUITE A
AURORA IL
60506-1403
US

IV. Provider business mailing address

1256 WATERFORD DRIVE SUITE 230
AURORA IL
60504
US

V. Phone/Fax

Practice location:
  • Phone: 630-896-0659
  • Fax: 630-896-0581
Mailing address:
  • Phone: 630-499-2404
  • Fax: 630-499-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036055932
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: