Individual
EDEN LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
722 W MAXWELL ST, CHICAGO, IL 60607-5002
(312) 996-2901
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036166519
IL
207Q00000X
Family Medicine Physician
A174549
CA
207Q00000X
Family Medicine Physician
LP04410
RI
Other
Enumeration date
04/02/2018
Last updated
01/02/2024
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