Individual
MICHEAL YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1730 E LAKE SHORE DR, DECATUR, IL 62521-3809
(217) 329-1000
(217) 329-1055
Mailing address
1730 E LAKE SHORE DR, DECATUR, IL 62521-3809
(217) 329-1000
(217) 329-1055
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036097611
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL2613
MEDICARE GROUP PTAN
IL
Enumeration date
09/14/2006
Last updated
07/29/2025
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