Provider Demographics
NPI:1306849989
Name:HUYOUNG, ALFRED R (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:R
Last Name:HUYOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 STRATHMOOR DR
Mailing Address - Street 2:STE 1
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5184
Mailing Address - Country:US
Mailing Address - Phone:815-227-5600
Mailing Address - Fax:815-227-9242
Practice Address - Street 1:5701 STRATHMOOR DR
Practice Address - Street 2:STE 1
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5184
Practice Address - Country:US
Practice Address - Phone:815-227-5600
Practice Address - Fax:815-227-9242
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist