MEDICARE: JIA YIN WEE M.ED., LPC

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
1	101YM0800X	Mental Health	178.012127	IL

General Provider Information

NPI Number	:	1558804963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIA YIN WEE M.ED., LPC

Provider Business Mailing Address
First Line	:	1134 W ARGYLE ST
Second Line	:	APT # 3W
City	:	CHICAGO
State	:	IL
Zip	:	60640-3610
Country	:	US
Telephone Number	:	312-215-7999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1134 W ARGYLE ST
Second Line	:	APT # 3W
City	:	CHICAGO
State	:	IL
Zip	:	60640-3610
Country	:	US
Telephone Number	:	312-215-7999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2016
Last Update Date	:	12/02/2016

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