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General NPI Number Information
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NPI Number | 1093759417
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Entity Type | Individual
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Provider Name | JOHN HONG SUK YANG MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 300 N MAPLE ST
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City | EFFINGHAM
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State | IL
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Zip | 62401-2003
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Country | US
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Telephone | 217-528-7541
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19248
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City | SPRINGFIELD
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State | IL
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Zip | 62794-9248
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Country | US
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Telephone | 217-528-7541
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2002021127
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2002021127
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101246386
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036166791
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License Number State | IL
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