Healthcare Provider Details

I. General information

NPI: 1700718194
Provider Name (Legal Business Name): SPRINGFIELD HAIR RESTORATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W ILES AVE
SPRINGFIELD IL
62704-4174
US

IV. Provider business mailing address

2020 W ILES AVE
SPRINGFIELD IL
62704-4174
US

V. Phone/Fax

Practice location:
  • Phone: 217-698-3030
  • Fax:
Mailing address:
  • Phone: 217-698-3030
  • Fax: 217-718-5687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SANDRA YEH
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 217-698-3030