Healthcare Provider Details

I. General information

NPI: 1114909942
Provider Name (Legal Business Name): MICHAEL P HU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 GARFIELD AVE STE 200
LIBERTYVILLE IL
60048-3100
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-7884
US

V. Phone/Fax

Practice location:
  • Phone: 847-549-1818
  • Fax: 847-680-1573
Mailing address:
  • Phone: 847-390-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD427894
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01053511A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036107310
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: