Provider Demographics
NPI:1558685115
Name:WAY-HOO DET, M.D., S.C.
Entity Type:Organization
Organization Name:WAY-HOO DET, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAY-HOO
Authorized Official - Middle Name:
Authorized Official - Last Name:DET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-886-3553
Mailing Address - Street 1:2007 MIDWEST CLUB PKWY
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2526
Mailing Address - Country:US
Mailing Address - Phone:630-325-3701
Mailing Address - Fax:630-325-3701
Practice Address - Street 1:845 N MICHIGAN AVE
Practice Address - Street 2:SUITE 948 E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2252
Practice Address - Country:US
Practice Address - Phone:312-202-0700
Practice Address - Fax:312-202-0326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036054528207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43810Medicare UPIN