Healthcare Provider Details

I. General information

NPI: 1396360665
Provider Name (Legal Business Name): MINTING YU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 S WOOD ST FL 4
CHICAGO IL
60612-3747
US

IV. Provider business mailing address

820 S. WOOD STREET (MC 675) SUITE 100
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-7598
  • Fax:
Mailing address:
  • Phone: 312-996-2933
  • Fax: 312-996-3050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036165364
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number036165364
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036165364
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: