Individual
DR. JACK S. WU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 W CENTRAL RD, DEPARTMENT OF EMERGENCY MEDICINE, ARLINGTON HEIGHTS, IL 60005-2349
(847) 618-3040
(847) 618-3049
Mailing address
800 W CENTRAL RD, DEPARTMENT OF EMERGENCY MEDICINE, ARLINGTON HEIGHTS, IL 60005-2349
(847) 618-3040
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-114930
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036114930
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
05
—
1154548089
—
IL
Enumeration date
04/20/2007
Last updated
07/14/2015
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