Provider Demographics
NPI:1821326984
Name:CHICAGO DIGESTIVE AND LIVER DISEASE SPECIALIST S C
Entity Type:Organization
Organization Name:CHICAGO DIGESTIVE AND LIVER DISEASE SPECIALIST S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-889-9889
Mailing Address - Street 1:3740 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4727
Mailing Address - Country:US
Mailing Address - Phone:630-889-9889
Mailing Address - Fax:
Practice Address - Street 1:3740 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-4727
Practice Address - Country:US
Practice Address - Phone:630-889-9889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty