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General NPI Number Information
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NPI Number | 1235883661
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Entity Type | Individual
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Provider Name | YOONMEE SONG NP-C
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Gender | Female
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 6400 SHAFER CT STE 300
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City | ROSEMONT
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State | IL
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Zip | 60018-4929
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Country | US
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Telephone | 847-759-9449
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 CORPORATE DR STE 400
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City | TROY
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State | MI
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Zip | 48098-2645
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Country | US
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Telephone | 866-902-5854
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Fax | 866-903-4000
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209024366
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209024366
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License Number State | IL
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