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General NPI Number Information
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NPI Number | 1659335495
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Entity Type | Individual
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Provider Name | YOUNG-IL RO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 3700 W 203RD ST STE 201
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1182
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Country | US
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Telephone | 708-679-2120
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Fax | 708-503-3230
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Provider Business Mailing Address
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Address Line | 35318 EAGLE WAY
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City | CHICAGO
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State | IL
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Zip | 60678-1353
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Country | US
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Telephone |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036059539
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License Number State | IL
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