Healthcare Provider Details

I. General information

NPI: 1346241585
Provider Name (Legal Business Name): DAVID C CHUA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 10/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1S280 SUMMIT AVE COURT A
OAKBROOK TERRACE IL
60181-3984
US

IV. Provider business mailing address

1S280 SUMMIT AVE COURT A
OAKBROOK TERRACE IL
60181-3984
US

V. Phone/Fax

Practice location:
  • Phone: 630-889-9889
  • Fax: 630-889-8977
Mailing address:
  • Phone: 630-889-9889
  • Fax: 630-889-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036069933
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: