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NPI Code Detail

MEDICARE: LU YE

MEDICARE: LU YE
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
1104100000XSocial Worker
21041C0700XClinical Social Worker150.103918IL

General Provider Information

NPI Number : 1184222762
Entity Type Code : Individual
Provider Name (Legal Business Name) : LU YE
Provider Business Mailing Address
First Line : PO BOX 5213
Second Line :
City : EVANSTON
State : IL
Zip : 60204-5213
Country : US
Telephone Number : 847-565-6400
Fax Number :
Provider Business Practice Location Address
First Line : 1854 SHERMAN AVE
Second Line :
City : EVANSTON
State : IL
Zip : 60201-3795
Country : US
Telephone Number : 847-565-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2020
Last Update Date : 06/20/2022

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Directions to “ LU YE ” Practice Location

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