MEDICARE: JAMES ALLEN YOUNG 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	208100000X	Physical Medicine & Rehabilitation Physician	036-079462	IL

General Provider Information

NPI Number	:	1588650188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ALLEN YOUNG MD

Provider Business Mailing Address
First Line	:	850 S WABASH AVE STE 210
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3642
Country	:	US
Telephone Number	:	312-589-3527
Fax Number	:	224-242-9002

Provider Business Practice Location Address
First Line	:	850 S WABASH AVE STE 210
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3642
Country	:	US
Telephone Number	:	312-589-3527
Fax Number	:	224-242-9002

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	05/31/2022

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