Healthcare Provider Details

I. General information

NPI: 1093409948
Provider Name (Legal Business Name): JOANNA YI-TING WU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 ROHLWING RD
ROLLING MEADOWS IL
60008-1338
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0850
  • Fax: 847-618-0859
Mailing address:
  • Phone: 847-570-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036181817
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: