Provider Demographics
NPI:1073579710
Name:YU, HUI FANG (OD)
Entity Type:Individual
Prefix:
First Name:HUI FANG
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JOSEPHINE
Other - Middle Name:HUI FANG
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:3060 OGDEN AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1685
Mailing Address - Country:US
Mailing Address - Phone:630-355-0789
Mailing Address - Fax:630-357-4457
Practice Address - Street 1:3060 OGDEN AVE
Practice Address - Street 2:STE 210
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1685
Practice Address - Country:US
Practice Address - Phone:630-355-0789
Practice Address - Fax:630-357-4457
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0002232363OtherBCBS
0002232363OtherBCBS