Provider Demographics
NPI:1144227877
Name:HUANG, CHIA (MD)
Entity Type:Individual
Prefix:
First Name:CHIA
Middle Name:
Last Name:HUANG
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 1:855 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4420
Mailing Address - Country:US
Mailing Address - Phone:708-492-4077
Mailing Address - Fax:708-386-2839
Practice Address - Street 1:2701 W 68TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-1813
Practice Address - Country:US
Practice Address - Phone:773-735-4884
Practice Address - Fax:773-735-2625
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036045227207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036045227Medicaid
IL1616108OtherBCBS
ILL20697Medicare PIN
IL110059943Medicare PIN
IL036045227Medicaid
ILC30486Medicare PIN
IL1616108OtherBCBS