Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 125.075699 | IL |
NPI | 1043765225 |
---|---|
Provider Name | Connie Hsu |
First Address | Burr Ridge, IL 60527-6686 |
Second Address | Evanston, IL 60201-1700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2016 |
Last Update Date | 28/04/2020 |