Individual
WILEY YAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18130 HALSTED ST, HOMEWOOD, IL 60430-2597
(708) 799-2550
Mailing address
M205 CANDLEWOOD CT, MARSHFIELD, WI 54449-8855
(715) 897-7898
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
021.003109
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2018
Last updated
09/28/2021
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