Provider Demographics
NPI:1225085046
Name:FILER, YOUNG JEE SON (MPT)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:JEE SON
Last Name:FILER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:YOUNG
Other - Middle Name:JEE ROSE
Other - Last Name:SON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:100 E WALTON
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-642-3963
Mailing Address - Fax:312-642-3966
Practice Address - Street 1:100 E WALTON
Practice Address - Street 2:SUITE 700
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-642-3963
Practice Address - Fax:312-642-3966
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILR00132Medicare PIN
ILK32094Medicare PIN
ILK32093Medicare PIN