MEDICARE: SEN-LIAN YANG MD

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
1	207V00000X	Obstetrics & Gynecology Physician	036048905	IL
2	207VE0102X	Reproductive Endocrinology Physician	036048905	IL
3	207VE0102X	Reproductive Endocrinology Physician	036-048905	IL
4	207V00000X	Obstetrics & Gynecology Physician	036-048905	IL

General Provider Information

NPI Number	:	1568573210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEN-LIAN YANG MD

Provider Business Mailing Address
First Line	:	6702 EAST NAVAJO DRIVE
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463
Country	:	US
Telephone Number	:	708-389-6541
Fax Number	:	708-385-9319

Provider Business Practice Location Address
First Line	:	9706 SOUTHWEST HIGHWAY
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453
Country	:	US
Telephone Number	:	708-422-2120
Fax Number	:	708-422-2168

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	12/21/2021

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