Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036.143352 | IL |
N | 111NI0900X | Internist | 036.143352 | IL |
N | 207R00000X | Internist | 65180 | WI |
N | 111NI0900X | Internist | 65180 | WI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036.143352 | IL |
NPI | 1629497557 |
---|---|
Provider Name | Mingxi Dennis Yu |
First Address | Maywood, IL 62786 |
Second Address | Maywood, IL 60153-3328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 30/06/2021 |