Provider Demographics
NPI:1720368657
Name:YOON, WILLIAM JHONGHOON (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JHONGHOON
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9650 GROSS POINT RD STE 4900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5080
Mailing Address - Country:US
Mailing Address - Phone:847-663-8050
Mailing Address - Fax:224-251-4407
Practice Address - Street 1:9650 GROSS POINT RD STE 4900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-5080
Practice Address - Country:US
Practice Address - Phone:847-663-8050
Practice Address - Fax:224-251-4407
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA157256208600000X, 2086S0129X
IL0361396972086S0129X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL336101086OtherIDFPR DIV. OF PROFESSIONAL REGULATION - LICENSED PHYSICIAN CONTROLLED SUBSTANCE
MI4301098262OtherBOARD OF MEDICINE LICENSE EDUCATIONAL LIMITED LICENSE
MI5315049698OtherBOARD OF PHARMACY CONTROLLED SUBSTANCE LICENSE
IL036139697OtherIDFPR DIVISION OF PROFESSIONAL REGULATION - LICENSED PHYSICIAN AND SURGEON