Provider Demographics
NPI:1548203615
Name:YANG, LEE C (DO)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:C
Last Name:YANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 958216
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195
Mailing Address - Country:US
Mailing Address - Phone:847-490-6960
Mailing Address - Fax:847-490-2916
Practice Address - Street 1:1555 NORTH BARRINGTON ROAD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194
Practice Address - Country:US
Practice Address - Phone:847-490-6960
Practice Address - Fax:847-490-2916
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097952207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094817Medicaid
IL036094817Medicaid