Provider Demographics
NPI:1710149489
Name:GROVES, YUANYUAN (MD)
Entity Type:Individual
Prefix:
First Name:YUANYUAN
Middle Name:
Last Name:GROVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YUANYUAN
Other - Middle Name:
Other - Last Name:WEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:331 W SURF ST STE 902
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-7227
Mailing Address - Country:US
Mailing Address - Phone:773-904-8641
Mailing Address - Fax:872-888-1206
Practice Address - Street 1:331 W SURF ST STE 902
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-7227
Practice Address - Country:US
Practice Address - Phone:773-904-8641
Practice Address - Fax:872-888-1206
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192978207Q00000X
ILCOVID-IMG-1805207Q00000X
1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine