Individual provider Active NPI

Stephen Yeh Jr., M.D.

  • Otolaryngology Physician
  • Chicago, IL
National Provider Identifier
1063484798
Registry record updated Apr 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036-046399 Issued in IL
Practice address
3860 West Ogden Avenue
Chicago, IL 60623
Phone
(872) 588-3000
Fax
(847) 998-0483
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036046399 IL
Otolaryngology Physician 207Y00000X 036-046399 IL Primary

Addresses

Primary practice location

3860 West Ogden Avenue
Chicago, IL 60623

Mailing address

3860 West Ogden Avenue
Chicago, IL 60623
Phone (872) 588-3000

Other identifiers 2

IdentifierTypeStateIssuer
036046399MedicaidIL
21608740OtherILBC BS OF ILLINOIS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-046399ILMDOtolaryngology Physician
036046399ILMDOtolaryngology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1063484798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 WEST OGDEN AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60623",
            "telephone_number": "872-588-3000",
            "fax_number": "847-998-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 WEST OGDEN AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60623",
            "telephone_number": "872-588-3000",
            "fax_number": "847-998-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEH",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036046399",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036-046399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036046399",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF ILLINOIS",
            "identifier": "21608740",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.