Provider Demographics
NPI:1629497557
Name:YU, MINGXI DENNIS
Entity Type:Individual
Prefix:
First Name:MINGXI
Middle Name:DENNIS
Last Name:YU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LOYOLA UNIVERSITY MEDICAL CENTER
Mailing Address - Street 2:2160 S. FIRST AVE. BUILDING 110, ROOM 6292
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:62786
Mailing Address - Country:US
Mailing Address - Phone:434-906-1934
Mailing Address - Fax:
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI65180207R00000X
IL036.143352207R00000X, 208M00000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist