Active NPI
Sijun Yang, MD
- Internal Medicine Physician
- Bolingbrook, IL
National Provider Identifier
1962653568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036-122231
- Practice address
- 454 W Boughton Rd Ste C
Bolingbrook, IL 60440-1378 - Phone
- (630) 778-8571
- Fax
- (630) 778-8572
- NPI assigned
- Oct 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-122231 | IL | Primary |
Addresses
Primary practice location
454 W Boughton Rd Ste C
Bolingbrook, IL 60440-1378
Mailing address
454 W Boughton Rd Ste C
Bolingbrook, IL 60440-1378
Phone (312) 823-3469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091118000729 | IL | Practitioner - Internal Medicine | 6305984931 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
454 W Boughton Rd
Suite C
Bolingbrook, IL 60440-1378
Phone (630) 759-0088
Hospital & facility affiliations
- Residential Home Health
- Uchicago Medicine Adventhealth Home Care
- Northwest Community Hospital 1
- Edward Hospital
- Uchicago Medicine Adventhealth Bolingbrook
- Elmhurst Memorial Hospital
- Uchicago Medicine Adventhealth Hinsdale
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-122231 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Naperville Medical Group Corporation | Internal Medicine | Current | Accepting new patients |
| Medicall Physicians Group, LTD. | Past | Accepting new patients |
Locations
454 W Boughton Rd
Ste C
Bolingbrook, IL 60440
Phone (312) 823-3469
1020 E Ogden Ave
Ste 314
Naperville, IL 60563
1260 Iroquois Ave
Ste 302
Naperville, IL 60563
Phone (630) 759-0088
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CCHJBD/Endpoint/CCHJBD
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Bolingbrook, IL
- NPI 1639489057
IL, Internal Medicine
-
- Geriatric Medicine (Internal Medicine) Physician
- Schaumburg, IL
- NPI 1194861286
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- La Grange, IL
- NPI 1457397317
-
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1578932869
Hospital
-
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1770531600
Hospital
-
- Home Health Agency
- Lisle, IL
- NPI 1336377365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639958400000",
"number": "1962653568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "454 W BOUGHTON RD STE C",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604401378",
"telephone_number": "312-823-3469",
"fax_number": "630-778-8572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "454 W BOUGHTON RD STE C",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604401378",
"telephone_number": "630-778-8571",
"fax_number": "630-778-8572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANG",
"first_name": "SIJUN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-02",
"last_updated": "2021-12-20",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-122231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.