Provider Demographics
NPI:1164408316
Name:HUANG, LI JUN (MD)
Entity Type:Individual
Prefix:DR
First Name:LI JUN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LILLY
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:805 QUAIL RIDGE DR
Mailing Address - Street 2:STE101
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-6164
Mailing Address - Country:US
Mailing Address - Phone:708-448-8470
Mailing Address - Fax:708-448-9651
Practice Address - Street 1:805 QUAIL RIDGE DR
Practice Address - Street 2:STE 206
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6164
Practice Address - Country:US
Practice Address - Phone:630-850-2120
Practice Address - Fax:630-850-2123
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-20
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL361083442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H81209Medicare UPIN
ILL99413Medicare ID - Type Unspecified