Healthcare Provider Details
I. General information
NPI: 1154565703
Provider Name (Legal Business Name): CANDICE W. YEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2009
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US
IV. Provider business mailing address
29373 NETWORK PL
CHICAGO IL
60673-1293
US
V. Phone/Fax
- Phone: 602-344-5404
- Fax: 602-344-5859
- Phone: 847-390-5900
- Fax: 847-390-4757
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | 41680 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 036176440 |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036176440 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: