Healthcare Provider Details

I. General information

NPI: 1396241188
Provider Name (Legal Business Name): SUYUE MICHAEL ZHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MIKE ZHANG

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 W WELLINGTON AVE
CHICAGO IL
60657-5147
US

IV. Provider business mailing address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

V. Phone/Fax

Practice location:
  • Phone: 773-975-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberU3389
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: