MEDICARE: PAULINE CHOU 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036068444	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	021622158	OTHER	IL	CMMG BLUE SHIELD

General Provider Information

NPI Number	:	1164422341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULINE CHOU M.D.

Provider Business Mailing Address
First Line	:	2300 N CHILDRENS PLZ
Second Line	:	BOX 17
City	:	CHICAGO
State	:	IL
Zip	:	60614-3363
Country	:	US
Telephone Number	:	773-880-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 N CHILDRENS PLZ
Second Line	:	PATHOLOGY LAB
City	:	CHICAGO
State	:	IL
Zip	:	60614-3363
Country	:	US
Telephone Number	:	773-880-4000
Fax Number	:

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/09/2007

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Directions to “ PAULINE CHOU M.D.” Practice Location

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