=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023161940
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM YAW-NTAAKU ASIHENE M.D, PH.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2007
-----------------------------------------------------
Last Update Date | 07/09/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12700 US HIGHWAY 34
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60545
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-552-9830
-----------------------------------------------------
Fax | 630-552-9841
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12700 US HIGHWAY 34
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60545-9002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-552-9830
-----------------------------------------------------
Fax | 630-552-9841
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 036129810
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 2007-01770
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------