Healthcare Provider Details

I. General information

NPI: 1285122713
Provider Name (Legal Business Name): LU YING HEI NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2018
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 22ND ST STE 1000
OAK BROOK IL
60523-2006
US

IV. Provider business mailing address

1301 W 22ND ST STE 1000
OAK BROOK IL
60523-2006
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-8241
  • Fax: 810-733-8241
Mailing address:
  • Phone: 810-733-8241
  • Fax: 810-733-8241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704277074
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704277074
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: