Healthcare Provider Details

I. General information

NPI: 1528449014
Provider Name (Legal Business Name): MICHAEL XIAOWEI CUI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2015
Last Update Date: 03/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE STE MC7082
CHICAGO IL
60637-1465
US

IV. Provider business mailing address

180 HARVESTER DR STE 110
BURR RIDGE IL
60527-6686
US

V. Phone/Fax

Practice location:
  • Phone: 773-795-0232
  • Fax:
Mailing address:
  • Phone: 737-702-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125066951
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: