Healthcare Provider Details

I. General information

NPI: 1558278234
Provider Name (Legal Business Name): YUXIANG OU PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

511 WILDFLOWER WAY
STREAMWOOD IL
60107-3389
US

V. Phone/Fax

Practice location:
  • Phone: 312-355-4300
  • Fax:
Mailing address:
  • Phone: 773-931-7547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.301726
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: