Provider Demographics
NPI:1912910175
Name:CHU, ELISE CAROLINE IRENE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISE
Middle Name:CAROLINE IRENE
Last Name:CHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELISE
Other - Middle Name:CAROLINE IRENE
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10099 RIDGEGATE PKWY
Mailing Address - Street 2:370
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5531
Mailing Address - Country:US
Mailing Address - Phone:303-795-3110
Mailing Address - Fax:303-795-6992
Practice Address - Street 1:10099 RIDGEGATE PKWY
Practice Address - Street 2:370
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5531
Practice Address - Country:US
Practice Address - Phone:303-795-3110
Practice Address - Fax:303-795-6992
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR44809207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology