Provider Demographics
NPI:1528197423
Name:KAO, LI-CHIUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:LI-CHIUNG
Middle Name:
Last Name:KAO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6040 IRENE DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-4579
Mailing Address - Country:US
Mailing Address - Phone:847-695-8184
Mailing Address - Fax:
Practice Address - Street 1:265 S. KINGERY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3019
Practice Address - Country:US
Practice Address - Phone:630-833-0177
Practice Address - Fax:630-833-0339
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist