Healthcare Provider Details

I. General information

NPI: 1154401750
Provider Name (Legal Business Name): ESTHER YI-HSIU LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 ROLLINS RD STE 1100
GURNEE IL
60031-1512
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-356-3680
  • Fax:
Mailing address:
  • Phone: 847-570-2040
  • Fax: 312-747-9447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-102832
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: