Individual
YI PANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-3849
(312) 225-6200
(312) 949-7660
Mailing address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-3849
(312) 949-7287
(312) 999-7363
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009799
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009799
—
IL
01
—
205785
PTAN IL MEDICARE COOK COUNTY
IL
Enumeration date
08/31/2005
Last updated
01/20/2012
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