Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 209010410 | IL |
NPI | 1003254475 |
---|---|
Provider Name | Mrs. Yang Xue |
First Address | Chicago, IL 60616 |
Second Address | Chicago, IL 60616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 03/09/2013 |