Provider Demographics
NPI:1568573210
Name:YANG, SEN-LIAN (MD)
Entity Type:Individual
Prefix:
First Name:SEN-LIAN
Middle Name:
Last Name:YANG
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 1:6702 EAST NAVAJO DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463
Mailing Address - Country:US
Mailing Address - Phone:708-389-6541
Mailing Address - Fax:708-385-9319
Practice Address - Street 1:9706 SOUTHWEST HIGHWAY
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:708-422-2120
Practice Address - Fax:708-422-2168
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036048905207V00000X, 207VE0102X
IL036-048905207VE0102X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D15518Medicare UPIN
782610Medicare ID - Type Unspecified