Healthcare Provider Details

I. General information

NPI: 1528482528
Provider Name (Legal Business Name): PAUL YEE O.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7536 W LAWRENCE AVE
HARWOOD HEIGHTS IL
60706-3432
US

IV. Provider business mailing address

7536 W LAWRENCE AVE
HARWOOD HEIGHTS IL
60706-3432
US

V. Phone/Fax

Practice location:
  • Phone: 773-807-6811
  • Fax:
Mailing address:
  • Phone: 773-807-6811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070019765
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: