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General NPI Number Information
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NPI Number | 1376994178
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Entity Type | Individual
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Provider Name | HYEYON IM PT, DPT, OCS
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Gender | Female
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 200 E ILLINOIS ST APT 3901
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City | CHICAGO
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State | IL
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Zip | 60611-6308
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Country | US
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Telephone | 312-620-2249
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E ILLINOIS ST APT 3901
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City | CHICAGO
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State | IL
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Zip | 60611-6308
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Country | US
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Telephone | 443-370-9405
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305210306
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT872146
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License Number State | DC
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