Provider Demographics
NPI:1578736112
Name:1-ON-1 MD, LLC
Entity Type:Organization
Organization Name:1-ON-1 MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-544-0200
Mailing Address - Street 1:3501 N SOUTHPORT AVE UNIT 495
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1475
Mailing Address - Country:US
Mailing Address - Phone:312-544-0200
Mailing Address - Fax:312-544-0299
Practice Address - Street 1:1828 W WEBSTER AVE STE 450
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2916
Practice Address - Country:US
Practice Address - Phone:312-544-0200
Practice Address - Fax:312-544-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL216457Medicare PIN