Provider Demographics
NPI:1548422744
Name:WU, ALISON RAE (MD)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:RAE
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1352 N LASALLE ST APT CH
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1911
Mailing Address - Country:US
Mailing Address - Phone:323-251-7703
Mailing Address - Fax:
Practice Address - Street 1:250 E SUPERIOR ST RM 5-2177
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2914
Practice Address - Country:US
Practice Address - Phone:312-472-4673
Practice Address - Fax:312-472-4687
Is Sole Proprietor?:No
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125054833207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL37571OtherEMPLOYEE ID NUMBER