Provider Demographics
NPI:1396709226
Name:KU, LI-MEI (DC)
Entity type:Individual
Prefix:DR
First Name:LI-MEI
Middle Name:
Last Name:KU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LI-MEI
Other - Middle Name:TSAI
Other - Last Name:KU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:122 HIDDENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2327
Mailing Address - Country:US
Mailing Address - Phone:708-422-1512
Mailing Address - Fax:708-422-1417
Practice Address - Street 1:3348 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2236
Practice Address - Country:US
Practice Address - Phone:708-422-1512
Practice Address - Fax:708-422-1417
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008343111N00000X
IL198-000368171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038008343Medicaid
IL038008343Medicaid
K51603Medicare PIN