Healthcare Provider Details

I. General information

NPI: 1649701889
Provider Name (Legal Business Name): DANIELLE YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 800
CHICAGO IL
60611-2978
US

IV. Provider business mailing address

5145 N CALIFORNIA AVE
CHICAGO IL
60625-3661
US

V. Phone/Fax

Practice location:
  • Phone: 312-206-9544
  • Fax:
Mailing address:
  • Phone: 773-989-3814
  • Fax: 773-989-6230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1649701889
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1649701889
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number036155285
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: