Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036152623 | IL |
N | 111NI0900X | Internist | 036152623 | IL |
N | 207RH0000X | Hematologist | 036152623 | IL |
Y | 207RH0003X | Hematology & Oncology | 01086913A | IN |
N | 207RX0202X | Medical Oncology | 036152623 | IL |
NPI | 1215341516 |
---|---|
Provider Name | Dr. Cai Yuan |
First Address | Rockford, IL 61103-3655 |
Second Address | Newburgh, IN 47630-7451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2014 |
Last Update Date | 28/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036152623 | (05) | IL |
1215341516 | (05) | WI |