Provider Demographics
NPI:1104812189
Name:CHIOU, YIHNAN (MD)
Entity type:Individual
Prefix:
First Name:YIHNAN
Middle Name:
Last Name:CHIOU
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 1:11650 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:WEST FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:62896-5036
Mailing Address - Country:US
Mailing Address - Phone:618-932-3287
Mailing Address - Fax:
Practice Address - Street 1:11650 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:WEST FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:62896-5036
Practice Address - Country:US
Practice Address - Phone:618-932-3287
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03650922207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD47085Medicare UPIN