Individual
KIRK PATRICK CHIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(224) 619-7221
Mailing address
2012 W 19TH ST, CHICAGO, IL 60608-2615
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125.082486
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125082486
IL
Other
Enumeration date
03/21/2023
Last updated
10/03/2023
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