Provider Demographics
NPI:1992202006
Name:HUANG, XIAO MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:XIAO
Middle Name:MICHELLE
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 63RD ST STE 103
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-2000
Mailing Address - Country:US
Mailing Address - Phone:630-969-7706
Mailing Address - Fax:
Practice Address - Street 1:412 63RD ST STE 103
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-2000
Practice Address - Country:US
Practice Address - Phone:630-969-7706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036159367207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology