Provider Demographics
NPI:1730353210
Name:IN HUH, M.D., S.C.
Entity type:Organization
Organization Name:IN HUH, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-769-3141
Mailing Address - Street 1:2740 W. FOSTER AVE. #309
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625
Mailing Address - Country:US
Mailing Address - Phone:773-769-3141
Mailing Address - Fax:
Practice Address - Street 1:2740 W FOSTER AVE STE 309
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3591
Practice Address - Country:US
Practice Address - Phone:773-769-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL20003284Medicaid
IL675270Medicare Oscar/Certification
IL20003284Medicaid