Chu, Gordon Kt
Chu, Gordon Kt is an individual health care provider with primary practice located at 305 W Jackson St Ste 400 , Carbondale IL 62901-1474. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Chu, Gordon Kt can be contacted via phone (618) 351-4972.Contact Information
Primary practice address
305 W Jackson St Ste 400
Carbondale IL 62901-1474
Phone: (618) 351-4972
Fax: (618) 351-4973
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 036119245 | Illinois |
Profile Details
| NPI number | 1235310756 |
|---|---|
| LBN Legal business name | Chu, Gordon Kt |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 27th, 2007 |
| Last updated | Mar 10th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235310756 | NPPES |
| Illinois | MEDICAID | 036119245 |
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