Provider Demographics
NPI:1891900890
Name:WU, IVAN TJ (AUD)
Entity Type:Individual
Prefix:MR
First Name:IVAN
Middle Name:TJ
Last Name:WU
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
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Mailing Address - Street 1:215 SHUMAN BLVD
Mailing Address - Street 2:STE 401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8458
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:978-313-6824
Practice Address - Street 1:411 E HUNTINGTON DR
Practice Address - Street 2:STE 121
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3731
Practice Address - Country:US
Practice Address - Phone:626-574-3138
Practice Address - Fax:626-574-3195
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2016-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAAU2044237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter