Provider Demographics
NPI:1477840833
Name:SUN, YIFEI (MD)
Entity Type:Individual
Prefix:DR
First Name:YIFEI
Middle Name:
Last Name:SUN
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 1:1800 E LAKE SHORE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-3810
Mailing Address - Country:US
Mailing Address - Phone:217-464-1722
Mailing Address - Fax:217-464-1717
Practice Address - Street 1:1800 E LAKE SHORE DR STE 1500
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521-3810
Practice Address - Country:US
Practice Address - Phone:217-464-1722
Practice Address - Fax:217-464-1717
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20160162592086S0129X
IL036.1446752086S0129X
MN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery