Doctor Name: | SUNTO YEN |
NPI Number: | 1255610937 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036099392 |
Business Practice Address: | 9865 W Roosevelt Rd #105 Westchester, IL - 601542767 |
Business Phone Number: | 7083441422 |
Business Fax Number: | 7083441481 |
Mailing Address: | 9865 W Roosevelt Rd, #105 WESTCHESTER |
State: | IL |
Postal Code: | 601542767 |
Phone Number: | 7083441422 |
Fax Number: | 7083441481 |
NPI Enumeration Date: | 08/11/2011 |
NPI Last Update Date: | 12/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036099392 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |