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NPI Code Detail

MEDICARE: TE SHAO HSU MD

MEDICARE: TE SHAO HSU MD
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
1207N00000XDermatology Physician036118825IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00612653OTHERILRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255300042
Entity Type Code : Individual
Provider Name (Legal Business Name) : TE SHAO HSU MD
Provider Business Mailing Address
First Line : 1860 PAYSPHERE CIR
Second Line :
City : CHICAGO
State : IL
Zip : 60674-0018
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 550 E DEVON AVE STE 200
Second Line :
City : ITASCA
State : IL
Zip : 60143-2639
Country : US
Telephone Number : 864-625-3376
Fax Number : 855-792-2250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2006
Last Update Date : 10/10/2018

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