Healthcare Provider Details

I. General information

NPI: 1700317773
Provider Name (Legal Business Name): ALEXANDER YEUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W CENTRAL RD STE 205
ARLINGTON HEIGHTS IL
60005-2465
US

IV. Provider business mailing address

1100 W CENTRAL RD STE 205
ARLINGTON HEIGHTS IL
60005-2465
US

V. Phone/Fax

Practice location:
  • Phone: 847-253-4040
  • Fax:
Mailing address:
  • Phone: 847-253-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036157343
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: