Provider Demographics
NPI:1124076724
Name:LIU, DENNIS B (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:B
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:225 E CHICAGO AVE
Mailing Address - Street 2:BOX 24
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2991
Mailing Address - Country:US
Mailing Address - Phone:312-227-6340
Mailing Address - Fax:312-227-9412
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:BOX 24
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-6340
Practice Address - Fax:312-227-9412
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2013-09-02
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Provider Licenses
StateLicense IDTaxonomies
IL036111648208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36111648Medicaid
I54157Medicare UPIN
IL36111648Medicaid