Provider Demographics
NPI:1598700221
Name:TUU DUC LE INC
Entity Type:Organization
Organization Name:TUU DUC LE INC
Other - Org Name:ST GILES 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 1:8035 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321
Mailing Address - Country:US
Mailing Address - Phone:219-836-2251
Mailing Address - Fax:219-836-2259
Practice Address - Street 1:8035 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321
Practice Address - Country:US
Practice Address - Phone:219-836-2251
Practice Address - Fax:219-836-2259
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:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000097525OtherBCBS ANTHEM
IN000000097525OtherBCBS ANTHEM