Basic Information
| Provider Information | |||||||||
| NPI: | 1841362829 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUI | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | YEEKWONG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DC, NMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1283 W DUNDEE RD | ||||||||
| Address2: | |||||||||
| City: | BUFFALO GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600894009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476329919 | ||||||||
| FaxNumber: | 8476329981 | ||||||||
| Practice Location | |||||||||
| Address1: | 1283 W DUNDEE RD | ||||||||
| Address2: | |||||||||
| City: | BUFFALO GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600894009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476329919 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2006 | ||||||||
| LastUpdateDate: | 04/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | 038.008505 | IL | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 111NR0400X | 038008505 | IL | Y | Chiropractic Providers | Chiropractor | Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 01635674 | 01 | IL | BLUE CROSS BLUE SHIELD | OTHER |