Healthcare Provider Details

I. General information

NPI: 1285825273
Provider Name (Legal Business Name): HUBERT JOHN YU SAM CHUA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 MILWAUKEE AVE STE 500
BURLINGTON WI
53105-1315
US

IV. Provider business mailing address

1660 FEEHANVILLE DR STE 450
MOUNT PROSPECT IL
60056-6023
US

V. Phone/Fax

Practice location:
  • Phone: 262-757-7752
  • Fax:
Mailing address:
  • Phone: 847-390-7666
  • Fax: 224-220-9345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070021174
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16160-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: