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General NPI Number Information
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NPI Number | 1770840555
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Entity Type | Organization
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Legal Business Name | ILLINOIS MEDICAL CARE AND CONSULTING, LLC
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 1104 W ARGYLE ST
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City | CHICAGO
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State | IL
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Zip | 60640-3610
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Country | US
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Telephone | 773-275-8300
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Fax | 773-275-8320
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Provider Business Mailing Address
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Address Line | 2932 WHISPERING OAKS DR
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-6329
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Country | US
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Telephone | 773-275-8300
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CHUNLIU ZHU
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Credential | MD
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Telephone | 773-275-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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