Healthcare Provider Details

I. General information

NPI: 1558819995
Provider Name (Legal Business Name): DR. SEIN HUR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W HARRISON ST
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

2550 BRIAN DR
NORTHBROOK IL
60062-7611
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-1608
  • Fax:
Mailing address:
  • Phone: 847-912-8942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.294492
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: