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Individual

SAM U HO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036-049378
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130000480
RR MEDICARE
01
216-09854-34
BC/BS
IL
01
638431
PTAN
IL
01
R014672
CHAMPUS
Enumeration date
03/28/2006
Last updated
03/02/2019
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