Provider Demographics
NPI:1255610937
Name:YEN, SUNTO (MD)
Entity type:Individual
Prefix:
First Name:SUNTO
Middle Name:
Last Name:YEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4413 ROOSEVELT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-2057
Mailing Address - Country:US
Mailing Address - Phone:708-344-1422
Mailing Address - Fax:708-344-1481
Practice Address - Street 1:4413 ROOSEVELT RD STE 101
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-2057
Practice Address - Country:US
Practice Address - Phone:708-344-1422
Practice Address - Fax:708-344-1481
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036099392208D00000X
IL036.099392225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice