Healthcare Provider Details

I. General information

NPI: 1184746422
Provider Name (Legal Business Name): DR. HUANG, XIURONG CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W 26TH ST UNIT B
CHICAGO IL
60616-4296
US

IV. Provider business mailing address

PO BOX 167207
CHICAGO IL
60616-7207
US

V. Phone/Fax

Practice location:
  • Phone: 312-225-9012
  • Fax: 312-225-9013
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. XIURONG LIU HUANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 312-225-9012