Provider Demographics
NPI:1558478487
Name:LIANG, TEHMING (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:TEHMING
Middle Name:
Last Name:LIANG
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 E BOUGHTON RD STE A
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2140
Mailing Address - Country:US
Mailing Address - Phone:630-972-2600
Mailing Address - Fax:630-972-2604
Practice Address - Street 1:580 E BOUGHTON RD STE A
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2140
Practice Address - Country:US
Practice Address - Phone:630-972-2600
Practice Address - Fax:630-972-2604
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036078279207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF10442Medicare UPIN
IL371660Medicare ID - Type Unspecified