Healthcare Provider Details

I. General information

NPI: 1427135805
Provider Name (Legal Business Name): S L YANG MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9706 SOUTHWEST HIGHWAY
OAK LAWN IL
60453-1779
US

IV. Provider business mailing address

6702 EAST NAVAJO DRIVE
PALOS HEIGHTS IL
60463-1779
US

V. Phone/Fax

Practice location:
  • Phone: 708-422-2120
  • Fax: 708-422-2168
Mailing address:
  • Phone: 708-389-6541
  • Fax: 708-385-9319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. SEN LIAN YANG
Title or Position: PRESIDENT
Credential:
Phone: 708-389-6541