Healthcare Provider Details

I. General information

NPI: 1134640956
Provider Name (Legal Business Name): YANTING WANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 S ASHLAND AVE APT 701
CHICAGO IL
60607-4187
US

IV. Provider business mailing address

903 S ASHLAND AVE APT 701
CHICAGO IL
60607-4187
US

V. Phone/Fax

Practice location:
  • Phone: 312-952-8058
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberTP111
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125069816
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: