Provider Demographics
NPI:1003344961
Name:HU, HAICHUN (LAC)
Entity Type:Individual
Prefix:
First Name:HAICHUN
Middle Name:
Last Name:HU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SHERMAN AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-4855
Mailing Address - Country:US
Mailing Address - Phone:630-920-3041
Mailing Address - Fax:
Practice Address - Street 1:1100 SHERMAN AVE STE 115
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4855
Practice Address - Country:US
Practice Address - Phone:630-920-3041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001320171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist