Provider Demographics
NPI:1962863951
Name:FELICIA CHU D.D.S., P.C.
Entity Type:Organization
Organization Name:FELICIA CHU D.D.S., P.C.
Other - Org Name:CELEBRATING SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-697-9000
Mailing Address - Street 1:750 FLETCHER DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4703
Mailing Address - Country:US
Mailing Address - Phone:847-697-9000
Mailing Address - Fax:847-697-3326
Practice Address - Street 1:750 FLETCHER DR
Practice Address - Street 2:SUITE 302
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4703
Practice Address - Country:US
Practice Address - Phone:847-697-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190233671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty