Provider Demographics
NPI:1255665444
Name:ZENG, MICHELLE YU (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:YU
Last Name:ZENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:234 W CERMAK RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4879
Mailing Address - Country:US
Mailing Address - Phone:312-808-0880
Mailing Address - Fax:312-808-0840
Practice Address - Street 1:234 W CERMAK RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4879
Practice Address - Country:US
Practice Address - Phone:312-808-0880
Practice Address - Fax:312-808-0840
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.123779207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036123779Medicaid
IL036123779Medicaid
IL1255665444Medicare PIN