Provider Demographics
NPI:1184668048
Name:YANG, HAOHUA I (MD)
Entity type:Individual
Prefix:
First Name:HAOHUA
Middle Name:I
Last Name:YANG
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 1:654 WEST VETERANS PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-1836
Mailing Address - Country:US
Mailing Address - Phone:630-553-3444
Mailing Address - Fax:630-553-3400
Practice Address - Street 1:654 WEST VETERANS PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1836
Practice Address - Country:US
Practice Address - Phone:630-553-3444
Practice Address - Fax:630-553-3400
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33494207R00000X
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0219303Medicaid
IA0219303Medicaid
H22943Medicare UPIN