Provider Demographics
NPI:1093779084
Name:CHIOU, DAVID YING FOONG (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:YING FOONG
Last Name:CHIOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:CHIOU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:157 N SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-2304
Mailing Address - Country:US
Mailing Address - Phone:847-566-0300
Mailing Address - Fax:847-566-2818
Practice Address - Street 1:157 N SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-2304
Practice Address - Country:US
Practice Address - Phone:847-566-0300
Practice Address - Fax:847-566-2818
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098964207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036098964Medicaid
ILP01420000OtherRAILROAD MEDICARE
IL036-098964OtherLICENSES
ILIL6778005Medicare PIN
ILP01420000OtherRAILROAD MEDICARE
IL209075007Medicare PIN