Provider Demographics
NPI:1295893881
Name:LO, SHU CHEN HELEN (DDS)
Entity type:Individual
Prefix:DR
First Name:SHU CHEN
Middle Name:HELEN
Last Name:LO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 HOBSON RD
Mailing Address - Street 2:#201
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517
Mailing Address - Country:US
Mailing Address - Phone:630-852-0676
Mailing Address - Fax:630-852-0626
Practice Address - Street 1:3510 HOBSON RD
Practice Address - Street 2:#201
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517
Practice Address - Country:US
Practice Address - Phone:630-852-0676
Practice Address - Fax:630-852-0626
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1004809Medicaid