Provider Demographics
NPI:1861792715
Name:ZHU, FANG (MD)
Entity type:Individual
Prefix:DR
First Name:FANG
Middle Name:
Last Name:ZHU
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 1:1740 W TAYLOR ST RM 2510
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7232
Mailing Address - Country:US
Mailing Address - Phone:312-996-0235
Mailing Address - Fax:
Practice Address - Street 1:1740 W TAYLOR ST RM 2510
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7232
Practice Address - Country:US
Practice Address - Phone:312-996-0235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361283722085N0904X, 2085R0202X, 207UN0902X
WAMD60958890207U00000X, 2085B0100X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0414583OtherL&I-SWEDISH RADIA EDMONDS
WA2140881Medicaid
WA0414574OtherL&I-RADIA REST OF WA
WA0414585OtherL&I-EVERGREEN RADIA
WA0414586OtherL&I-SOUTH SOUND RADIOLOGY
WA0414587OtherL&I-SEATTLE RADIOLOGY
WA0414577OtherL&I-RADIA KING COUNTY