Provider Demographics
NPI:1346241585
Name:CHUA, DAVID C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:CHUA
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 1:1S280 SUMMIT AVE
Mailing Address - Street 2:COURT A
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3984
Mailing Address - Country:US
Mailing Address - Phone:630-889-9889
Mailing Address - Fax:630-889-8977
Practice Address - Street 1:1S280 SUMMIT AVE
Practice Address - Street 2:COURT A
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3984
Practice Address - Country:US
Practice Address - Phone:630-889-9889
Practice Address - Fax:630-889-8977
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069933207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036069933Medicaid
IL405701Medicare ID - Type Unspecified
ILL62550Medicare PIN
ILC45232Medicare UPIN