Healthcare Provider Details

I. General information

NPI: 1518196377
Provider Name (Legal Business Name): YING ZHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OGDEN AVE
AURORA IL
60504-7222
US

IV. Provider business mailing address

2000 OGDEN AVE
AURORA IL
60504-7222
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-6250
  • Fax: 630-978-6869
Mailing address:
  • Phone: 630-978-6250
  • Fax: 630-978-6869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number125-055910
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number036.134579
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: