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Individual

DR. JUDY C. FAN-HSU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
500 W SUPERIOR ST, UNIT 1704, CHICAGO, IL 60654-8132
(240) 888-7924
Mailing address
500 W SUPERIOR ST, UNIT 1704, CHICAGO, IL 60654-8132
(240) 888-7924

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13827
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019.029661
ILLINOIS DENTAL LICENSE
IL
01
13827
MARYLAND DENTAL LICENSE
MD
Enumeration date
05/21/2007
Last updated
05/29/2015
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