Provider Demographics
NPI:1801108261
Name:YAO-HONG, TAMMY Y (DO)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:Y
Last Name:YAO-HONG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:YUAN
Other - Middle Name:
Other - Last Name:YAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1819 S MICHIGAN AVE
Mailing Address - Street 2:UNIT 410
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4638
Mailing Address - Country:US
Mailing Address - Phone:312-912-1042
Mailing Address - Fax:
Practice Address - Street 1:2650 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1718
Practice Address - Country:US
Practice Address - Phone:847-570-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125057961207R00000X
CA20A12801207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine