Provider Demographics
NPI:1003272105
Name:TO, YULEUNG ERIC (PSYD)
Entity Type:Individual
Prefix:DR
First Name:YULEUNG
Middle Name:ERIC
Last Name:TO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 RENAISSANCE DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1329
Mailing Address - Country:US
Mailing Address - Phone:224-625-0280
Mailing Address - Fax:
Practice Address - Street 1:1400 RENAISSANCE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1329
Practice Address - Country:US
Practice Address - Phone:224-625-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006567103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical