DR. DANIEL ZHIDI LIU, M.D. - NPI NUMBER 1104931286

Summary

Provider Name: DR. DANIEL ZHIDI LIU, M.D.

NPI Number: 1104931286

Clasification: Surgery (2086S0122X)

Specialization: Plastic and Reconstructive Surgery

Organization: UNIVERSITY PLASTIC SURGERY 1, LLC

Address:
9000 WAUKEGAN RD
SUITE 210
MORTON GROVE, IL
ZIP 60053

Phone Number: (847) 967-5120



Detailed Information

DR. Daniel Zhidi Liu, M.D. is a plastic and reconstructive surgeon in Morton Grove, IL with 8 years of experience. The provider is a surgeon who specializes in plastic and reconstructive surgery. The assigned NPI number for this provider is 1104931286 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year: 2006

The provider's business address is:

9000 WAUKEGAN RD
SUITE 210
MORTON GROVE, IL
ZIP 60053-127
Phone: (847) 967-5120
Fax: (847) 967-5125

The enumeration date for this NPI number is 8/20/2006 and was last updated on 6/26/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 2086S0122X Surgery Plastic and Reconstructive Surgery MD60024722 WA No
2 2086S0122X Surgery Plastic and Reconstructive Surgery 036129960 IL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 335110 MEDICARE UPIN WA

NPI Record

No. Field Name Field Value
1 NPI 1104931286
2 Entity Type Code 1
3 Provider Last Name Legal Name LIU
4 Provider First Name DANIEL
5 Provider Middle Name ZHIDI
6 Provider Name Prefix Text DR.
7 Provider Credential Text M.D.
8 Provider First Line Business Practice Location Address 9000 WAUKEGAN RD
9 Provider Second Line Business Practice Location Address SUITE 210
10 Provider Business Practice Location Address City Name MORTON GROVE
11 Provider Business Practice Location Address State Name IL
12 Provider Business Practice Location Address Postal Code 600532127
13 Provider Business Practice Location Address Country Code If outside U S US
14 Provider Business Practice Location Address Telephone Number 8479675120
15 Provider Business Practice Location Address Fax Number 8479675125
16 Provider Enumeration Date 8/20/2006
17 Last Update Date 6/26/2012
18 Provider Gender Code M
19 Healthcare Provider Taxonomy Code 1 2086S0122X
20 Provider License Number 1 MD60024722
21 Provider License Number State Code 1 WA
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 2086S0122X
24 Provider License Number 2 036129960
25 Provider License Number State Code 2 IL
26 Healthcare Provider Primary Taxonomy Switch 2 Y
27 Other Provider Identifier 1 335110
28 Other Provider Identifier Type Code 1 02
29 Other Provider Identifier State 1 WA
30 Is Sole Proprietor N

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.