Healthcare Provider Details

I. General information

NPI: 1457573420
Provider Name (Legal Business Name): VIVIAN HSUN-CHIEN CHOU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 RIDGE AVE SUITE 211A
EVANSTON IL
60201-2455
US

IV. Provider business mailing address

2500 RIDGE AVE SUITE 211A
EVANSTON IL
60201
US

V. Phone/Fax

Practice location:
  • Phone: 847-328-7909
  • Fax: 847-328-7919
Mailing address:
  • Phone: 847-328-7909
  • Fax: 847-328-7919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number036114020
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: