Organization
QUN WU MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA J RATCLIFFE (CHIEF OPERATIONS OFFICER)
(773) 239-9600
Entity
Organization
Contact information
Practice address
855 W 103RD ST, 100, CHICAGO, IL 60643-2357
(773) 239-9600
(773) 239-9601
Mailing address
855 W 103RD ST, 100, CHICAGO, IL 60643-2357
(773) 239-9600
(773) 239-9601
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
036125727
IL
261QM0850X
Adult Mental Health Clinic/Center
036125727
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
036125727
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036125727
—
IL
Enumeration date
05/02/2012
Last updated
05/02/2012
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