Provider Demographics
NPI:1801823604
Name:YOUNT, WILLIAM V (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:V
Last Name:YOUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5224 N WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2223
Mailing Address - Country:US
Mailing Address - Phone:773-989-7793
Mailing Address - Fax:
Practice Address - Street 1:901 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2901
Practice Address - Country:US
Practice Address - Phone:219-836-7049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061702A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200838410Medicaid
IL90001082OtherBCBS
INP00339707OtherRAILROAD
IN000000500544OtherANTHEM BCBS
IL036088762Medicaid
INF95457Medicare UPIN
IN201420OMedicare ID - Type Unspecified