Individual
PHILLIP C WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 DAVIS ST, SUITE 810, EVANSTON, IL 60201-4668
(847) 424-1100
(847) 864-6138
Mailing address
500 DAVIS ST, SUITE 810, EVANSTON, IL 60201-4668
(847) 424-1100
(847) 864-6138
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031600193
BLUE SHIELD
IL
01
—
0707260001
DMERC
IL
01
—
1638347
BLUE SHIELD ID
IL
01
—
P00147750
RAILROAD MEDICARE
IL
Enumeration date
01/12/2006
Last updated
02/28/2008
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