Healthcare Provider Details

I. General information

NPI: 1205583952
Provider Name (Legal Business Name): YOUJEIN HUR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E HAWTHORN PKWY
VERNON HILLS IL
60061-1462
US

IV. Provider business mailing address

1107 REGENCY LN
LIBERTYVILLE IL
60048-3039
US

V. Phone/Fax

Practice location:
  • Phone: 847-996-1707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070022627
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: