Organization Active NPI

Qun Wu MD

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1669730107
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
036125727 Issued in IL
Legal business name
QUN WU MD
Practice address
855 W 103Rd St
100
Chicago, IL 60643-2357
Phone
(773) 239-9600
Fax
(773) 239-9601
NPI assigned
May 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Angela J Ratcliffe
Title
Chief Operations Officer
Phone
(773) 239-9600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 036125727 IL Primary
Adult Mental Health Clinic/Center 261QM0850X 036125727 IL
Adolescent and Children Mental Health Clinic/Center 261QM0855X 036125727 IL

Addresses

Primary practice location

855 W 103Rd St
100
Chicago, IL 60643-2357

Mailing address

855 W 103Rd St
100
Chicago, IL 60643-2357
Phone (773) 239-9600

Other identifiers 1

IdentifierTypeStateIssuer
036125727MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1669730107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 W 103RD ST",
            "address_2": "100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432357",
            "telephone_number": "773-239-9600",
            "fax_number": "773-239-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 W 103RD ST",
            "address_2": "100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432357",
            "telephone_number": "773-239-9600",
            "fax_number": "773-239-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUN WU MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "RATCLIFFE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "773-239-9600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "036125727",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "036125727",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "IL",
            "license": "036125727",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036125727",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.