Provider Demographics
NPI:1083089866
Name:HU, CHUNG HSIN
Entity Type:Individual
Prefix:
First Name:CHUNG HSIN
Middle Name:
Last Name:HU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7913 KNOTTINGHAM CIR APT D
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-4971
Mailing Address - Country:US
Mailing Address - Phone:815-325-4136
Mailing Address - Fax:
Practice Address - Street 1:7900 CASS AVE STE 200
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5073
Practice Address - Country:US
Practice Address - Phone:331-529-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-05
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.428128163W00000X
IL209027225363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse