Provider Demographics
NPI:1568616787
Name:SHIN, CHU RI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHU
Middle Name:RI
Last Name:SHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1111 HIGHLAND AVE
Mailing Address - Street 2:WIMR 4151
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2275
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-0001
Practice Address - Country:US
Practice Address - Phone:608-263-6200
Practice Address - Fax:608-265-9721
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI567362080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology