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General NPI Number Information
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NPI Number | 1043439748
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Entity Type | Individual
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Provider Name | JOHN W HSU MD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 200 E PENNSYLVANIA AVE SUITE 212
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City | PEORIA
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State | IL
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Zip | 61603-3089
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Country | US
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Telephone | 309-676-8123
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Fax | 309-676-8455
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Provider Business Mailing Address
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Address Line | 200 E PENNSYLVANIA AVE SUITE 212
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City | PEORIA
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State | IL
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Zip | 61603-3089
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Country | US
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Telephone | 309-676-8123
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Fax | 309-676-8455
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | 43890
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD433479
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | 036129902
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License Number State | IL
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