Provider Demographics
NPI:1497039093
Name:YI, YUNI K (RPH)
Entity Type:Individual
Prefix:
First Name:YUNI
Middle Name:K
Last Name:YI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 CAMBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-3230
Mailing Address - Country:US
Mailing Address - Phone:262-827-0449
Mailing Address - Fax:
Practice Address - Street 1:2815 CAMBRIDGE CIR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-3230
Practice Address - Country:US
Practice Address - Phone:262-827-0449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-01
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12044-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33012300Medicaid