MEDICARE: DR. LEWIS LI-YEN HSU M.D., PH.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	208000000X	Pediatrics Physician	036128130	IL
2	2080P0207X	Pediatric Hematology & Oncology Physician	MD044248L	PA
3	2080P0207X	Pediatric Hematology & Oncology Physician	036128130	IL
4	2080P0207X	Pediatric Hematology & Oncology Physician	MD037835	DC

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851357388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEWIS LI-YEN HSU M.D., PH.D.

Provider Business Mailing Address
First Line	:	840 S WOOD ST
Second Line	:	MC 856
City	:	CHICAGO
State	:	IL
Zip	:	60612-4325
Country	:	US
Telephone Number	:	312-996-6143
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 W TAYLOR ST
Second Line	:	SUITE 2E
City	:	CHICAGO
State	:	IL
Zip	:	60612-4795
Country	:	US
Telephone Number	:	312-996-6143
Fax Number	:	312-413-9484

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

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	01/05/2022

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Directions to “ DR. LEWIS LI-YEN HSU M.D., PH.D.” Practice Location

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