Provider Demographics
NPI:1285732651
Name:HUH, IN (MD)
Entity type:Individual
Prefix:DR
First Name:IN
Middle Name:
Last Name:HUH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 W FOSTER AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3500
Mailing Address - Country:US
Mailing Address - Phone:773-769-3141
Mailing Address - Fax:773-769-1458
Practice Address - Street 1:2740 W FOSTER AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3500
Practice Address - Country:US
Practice Address - Phone:773-769-3141
Practice Address - Fax:773-769-1458
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03653425207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL000546694002OtherUNITED HEALTH CARE
IL036053425Medicaid
IL4074760OtherAETNA
IL71300017OtherCIGNA HMO
IL21609644OtherBLUE SHIELD PROVIDER NUMB
IL21609644OtherBLUE SHIELD PROVIDER NUMB
IL71300017OtherCIGNA HMO