Provider Demographics
NPI:1639489057
Name:NAPERVILLE MEDICAL GROUP CORPORATION
Entity Type:Organization
Organization Name:NAPERVILLE MEDICAL GROUP CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SIJUN YANG
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:630-416-3191
Mailing Address - Street 1:1308 LITTLE BERRY CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-1751
Mailing Address - Country:US
Mailing Address - Phone:630-416-3191
Mailing Address - Fax:630-416-3191
Practice Address - Street 1:454 W BOUGHTON RD STE C
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1378
Practice Address - Country:US
Practice Address - Phone:312-823-3469
Practice Address - Fax:630-759-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty