Provider Demographics
NPI:1770826638
Name:FUJIHASHI, MASAYUKI (DN, ATC)
Entity Type:Individual
Prefix:DR
First Name:MASAYUKI
Middle Name:
Last Name:FUJIHASHI
Suffix:
Gender:M
Credentials:DN, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 N SHERIDAN RD
Mailing Address - Street 2:#11C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4771
Mailing Address - Country:US
Mailing Address - Phone:312-841-9445
Mailing Address - Fax:
Practice Address - Street 1:5701 N SHERIDAN RD
Practice Address - Street 2:#11C
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-4771
Practice Address - Country:US
Practice Address - Phone:312-841-9445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181.000369172P00000X
IL096.0018992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer