Individual
JOHN YONG BAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 W CRYSTAL LN, MOUNT PROSPECT, IL 60056-5459
(224) 210-0122
Mailing address
1717 W CRYSTAL LN, MOUNT PROSPECT, IL 60056-5459
(224) 210-0122
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209028606
IL
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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