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General NPI Number Information
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NPI Number | 1871852251
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Entity Type | Organization
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Legal Business Name | YING G HENSEL MD LLC
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 310 HAPP RD SUITE 207
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City | NORTHFIELD
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State | IL
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Zip | 60093-3455
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Country | US
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Telephone | 847-784-5200
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Fax | 847-784-5201
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Provider Business Mailing Address
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Address Line | 310 HAPP RD SUITE 207
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City | NORTHFIELD
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State | IL
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Zip | 60093-3455
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Country | US
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Telephone | 847-784-5200
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Fax | 847-784-5201
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Authorized Official
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Title or Position | MANAGER
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Name | SAMIRA MENDOZA
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Credential |
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Telephone | 630-628-9600
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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 | 036098890
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License Number State | IL
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