Wu, Simon K
Wu, Simon K is an individual health care provider with primary practice located at 400 N Wall St Ste 303 , Kankakee IL 60901-2964. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wu, Simon K can be contacted via phone (815) 933-1664.Contact Information
Primary practice address
400 N Wall St Ste 303
Kankakee IL 60901-2964
Phone: (815) 933-1664
Fax: (815) 935-5660
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036089802 | Illinois |
Profile Details
| NPI number | 1407044241 |
|---|---|
| LBN Legal business name | Wu, Simon K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2007 |
| Last updated | Sep 12th, 2018 - about 6 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 | 1407044241 | NPPES |
| Other | 04623007 | BCBS OF ILLINOIS | |
| MEDICAID | 036089802 | BCBS OF ILLINOIS |
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