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NPI Code Detail

MEDICARE: YIU-TUNG DAVID LEE OD

MEDICARE: YIU-TUNG DAVID LEE OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist046007894IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518950054
Entity Type Code : Individual
Provider Name (Legal Business Name) : YIU-TUNG DAVID LEE OD
Provider Business Mailing Address
First Line : 3241 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60616-3849
Country : US
Telephone Number : 312-949-7174
Fax Number : 312-949-7356
Provider Business Practice Location Address
First Line : 3241 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60616-3849
Country : US
Telephone Number : 312-225-6200
Fax Number : 312-949-7660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 12/18/2008

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Directions to “ YIU-TUNG DAVID LEE OD” Practice Location

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