Healthcare Provider Details

I. General information

NPI: 1770739252
Provider Name (Legal Business Name): CHIH-PIN HSIUNG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N CHILDRENS PLZ
CHICAGO IL
60614-3363
US

IV. Provider business mailing address

1000 N LAKE SHORE DR UNIT 606
CHICAGO IL
60611-1308
US

V. Phone/Fax

Practice location:
  • Phone: 773-880-4000
  • Fax:
Mailing address:
  • Phone: 631-786-5902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number036120581
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: