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NPI Code Detail

MEDICARE: DR. JOHN HONG SUK YANG MD

MEDICARE: DR. JOHN HONG SUK YANG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician2002021127MO
2207RC0000XCardiovascular Disease Physician2002021127MO
3207RC0000XCardiovascular Disease Physician0101246386VA
4207RC0000XCardiovascular Disease Physician036166791IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093759417
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN HONG SUK YANG MD
Provider Business Mailing Address
First Line : PO BOX 19248
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62794-9248
Country : US
Telephone Number : 217-528-7541
Fax Number :
Provider Business Practice Location Address
First Line : 300 N MAPLE ST
Second Line :
City : EFFINGHAM
State : IL
Zip : 62401-2003
Country : US
Telephone Number : 217-528-7541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 03/10/2025

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