MEDICARE: DR. LINDA HUANG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036094378	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1470865	OTHER		UNITED HEALTHCARE
2	5837564	OTHER		AETNA
3	0001638964	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1114083730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA HUANG M.D.

Provider Business Mailing Address
First Line	:	3501 N SOUTHPORT AVE UNIT 495
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1475
Country	:	US
Telephone Number	:	312-544-0200
Fax Number	:	312-544-0299

Provider Business Practice Location Address
First Line	:	1828 W WEBSTER AVE STE 450
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-2916
Country	:	US
Telephone Number	:	312-544-0200
Fax Number	:	312-544-0299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	08/25/2021

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