Provider Demographics
NPI:1629296363
Name:YUE, ISAAC C (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:C
Last Name:YUE
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7034 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4306
Mailing Address - Country:US
Mailing Address - Phone:773-889-9100
Mailing Address - Fax:
Practice Address - Street 1:7034 W NORTH AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-6074
Practice Address - Country:US
Practice Address - Phone:773-889-9100
Practice Address - Fax:773-545-3636
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL210021411223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics