Individual
TE SHAO HSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 E DEVON AVE STE 200, ITASCA, IL 60143-2639
(864) 625-3376
(855) 792-2250
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036118825
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118825
—
IL
01
—
P00612653
RR MEDICARE
IL
Enumeration date
03/15/2006
Last updated
10/10/2018
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