Provider Demographics
NPI:1669647699
Name:YNGSON, YUNDEE (PT)
Entity Type:Individual
Prefix:MR
First Name:YUNDEE
Middle Name:
Last Name:YNGSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18618 CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-3536
Mailing Address - Country:US
Mailing Address - Phone:708-890-0077
Mailing Address - Fax:
Practice Address - Street 1:18618 CARPENTER ST
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-3536
Practice Address - Country:US
Practice Address - Phone:708-890-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070015213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist