Provider Demographics
NPI:1558400481
Name:YANG, LILI SHIAO (MS PT)
Entity Type:Individual
Prefix:MRS
First Name:LILI
Middle Name:SHIAO
Last Name:YANG
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1030 LONGFORD DR
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2630
Mailing Address - Country:US
Mailing Address - Phone:630-353-0985
Mailing Address - Fax:
Practice Address - Street 1:805 PLAINFIELD RD
Practice Address - Street 2:STE 112
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4287
Practice Address - Country:US
Practice Address - Phone:630-789-8080
Practice Address - Fax:630-789-8088
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00318177Medicare PIN
ILK23552Medicare PIN