Individual provider Active NPI

Shing I Yen, MD

  • Orthopaedic Surgery Physician
  • Blue Island, IL
National Provider Identifier
1093779373
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036046660 Issued in IL
Practice address
2320 High St
Retired 12-31-2014
Blue Island, IL 60406-2426
Phone
(708) 388-5500
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036046660 IL Primary

Addresses

Primary practice location

2320 High St
Retired 12-31-2014
Blue Island, IL 60406-2426

Mailing address

2320 High St
Blue Island, IL 60406-2426
Phone (708) 388-5500

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
036046660ILMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1093779373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 HIGH ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062426",
            "telephone_number": "708-388-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 HIGH ST",
            "address_2": "RETIRED 12-31-2014",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062426",
            "telephone_number": "708-388-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEN",
        "first_name": "SHING",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036046660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.