Provider Demographics
NPI:1912969726
Name:TSE, WILLIAM TSUN-YAN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TSUN-YAN
Last Name:TSE
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:PO BOX 776978
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6879
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:411 E CHESTNUT ST # 4B
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1713
Practice Address - Country:US
Practice Address - Phone:502-588-3600
Practice Address - Fax:502-588-9536
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA548452080P0207X
MA1519892080P0207X
IL0361104782080P0207X
KY509652080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036110478Medicaid
IL036110478Medicaid
ILK06021Medicare ID - Type Unspecified