Provider Demographics
NPI:1346408176
Name:LIAO, ALBERT YA-DEK (OD)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:YA-DEK
Last Name:LIAO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1012
Mailing Address - Country:US
Mailing Address - Phone:847-473-2568
Mailing Address - Fax:
Practice Address - Street 1:3900 FOUNTAIN SQUARE PL
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-6708
Practice Address - Country:US
Practice Address - Phone:847-473-2568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6750TG152W00000X
IL046010524152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist