Provider Demographics
NPI:1114083730
Name:HUANG, LINDA (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 N SOUTHPORT AVE UNIT 495
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1475
Mailing Address - Country:US
Mailing Address - Phone:312-544-0200
Mailing Address - Fax:312-544-0299
Practice Address - Street 1:1828 W WEBSTER AVE STE 450
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2916
Practice Address - Country:US
Practice Address - Phone:312-544-0200
Practice Address - Fax:312-544-0299
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094378207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1470865OtherUNITED HEALTHCARE
5837564OtherAETNA
IL0001638964OtherBLUE CROSS BLUE SHIELD
ILL69634Medicare PIN
1470865OtherUNITED HEALTHCARE
IL0001638964OtherBLUE CROSS BLUE SHIELD
IL0001638964OtherBLUE CROSS BLUE SHIELD