Provider Demographics
NPI:1538104252
Name:TUU DUC LE INC
Entity Type:Organization
Organization Name:TUU DUC LE INC
Other - Org Name:AURORA ORTHOPEDIC LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TUU
Authorized Official - Middle Name:DUC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-897-6363
Mailing Address - Street 1:PO BOX 182
Mailing Address - Street 2:110 JOHN ST
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542
Mailing Address - Country:US
Mailing Address - Phone:630-897-6363
Mailing Address - Fax:630-897-7663
Practice Address - Street 1:110 JOHN ST
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542
Practice Address - Country:US
Practice Address - Phone:630-897-6363
Practice Address - Fax:630-897-7663
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUU DUC LE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04519535OtherBCBS
IL=========002Medicaid
IL=========001Medicaid
IL=========001Medicaid
IL04519535OtherBCBS