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General NPI Number Information
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NPI Number | 1245125590
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Entity Type | Individual
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Provider Name | YONGXUAN DU
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1917 S MATTIS AVE APT 307
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City | CHAMPAIGN
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State | IL
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Zip | 61821-5934
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Country | US
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Telephone | 734-489-3730
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Fax |
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Provider Business Mailing Address
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Address Line | 1917 S MATTIS AVE
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City | CHAMPAIGN
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State | IL
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Zip | 61821-5920
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Country | US
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Telephone | 734-489-3730
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.117218
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851120061
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWIA.SC.61690299
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 128373
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License Number State | NY
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