Active NPI
Yang Liu
- Physical Therapy Assistant
- Bolingbrook, IL
National Provider Identifier
1104205418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2115443
- Practice address
- 316 Autumn Wind CT
Bolingbrook, IL 60440-2887 - Phone
- (630) 215-6976
- NPI assigned
- May 20, 2015
- Last updated
- Dec 10, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2115443 | TX | Primary |
Addresses
Primary practice location
316 Autumn Wind CT
Bolingbrook, IL 60440-2887
Mailing address
2400 Daybreak Dr
Rockwall, TX 75032-7259
Phone (630) 215-6976
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2115443 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1104205418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 DAYBREAK DR",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750327259",
"telephone_number": "630-215-6976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 AUTUMN WIND CT",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604402887",
"telephone_number": "630-215-6976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "YANG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-20",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2115443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
- Karen S Lindenmeyer, LCPC
- Benjamin Dean Lindflott, PT, DPT
- Lines of Communication Speech and Language Therapy, PLLC
- Katie Lynn Spencer Lisko, ATC
- Brittney Little, LPC
- LMR Home Health Care, Inc. (LMR Home Health DME)
- LMR Home Health Care, Inc.
- LMR Home Health Care, Inc. (LMR Home Maker)
- LMR Home Health Care, Inc. (LMR Home Nursing)
- LMR Medical Equipment, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.