Healthcare Provider Details

I. General information

NPI: 1588085138
Provider Name (Legal Business Name): STEVEN HSU D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2013
Last Update Date: 12/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9415 S. WESTERN AVE. SUITE 207
CHICAGO IL
60620
US

IV. Provider business mailing address

9415 S. WESTERN AVE. SUITE 207
CHICAGO IL
60620
US

V. Phone/Fax

Practice location:
  • Phone: 309-472-1268
  • Fax:
Mailing address:
  • Phone: 309-472-1268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.012233
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: