MEDICARE: SERAFIN CHUA 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	207P00000X	Emergency Medicine Physician	15019	MS
2	207RR0500X	Rheumatology Physician	036091861	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

General Provider Information

NPI Number	:	1407872351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERAFIN CHUA M.D.

Provider Business Mailing Address
First Line	:	2653 W OGDEN AVE
Second Line	:	3RD FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60608-1647
Country	:	US
Telephone Number	:	773-257-6730
Fax Number	:	773-257-4775

Provider Business Practice Location Address
First Line	:	2653 W OGDEN AVE
Second Line	:	3RD FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60608-1647
Country	:	US
Telephone Number	:	773-257-6730
Fax Number	:	773-257-4775

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	02/10/2014

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