1588860407 NPI number — MS. FANGFANG YE ACUPUNCTURIST

Table of content: MS. FANGFANG YE ACUPUNCTURIST (NPI 1588860407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588860407 NPI number — MS. FANGFANG YE ACUPUNCTURIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YE
Provider First Name:
FANGFANG
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ACUPUNCTURIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YE
Provider Other First Name:
KARI
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ACUPUNTURIST
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1588860407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 E GOLF RD STE 108
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON HEIGHTS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60005-4065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-290-8339
Provider Business Mailing Address Fax Number:
847-290-8366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 E GOLF RD
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
ARLINGTON HEIGHTS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60005-4089
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-290-8339
Provider Business Practice Location Address Fax Number:
847-290-8366
Provider Enumeration Date:
06/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  198-000557 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 35-2253044 . This is a "IRS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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