Basic Information
Provider Information
NPI: 1043278120
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUO
FirstName: YILI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1730 PARK ST
Address2: SUITE 101
City: NAPERVILLE
State: IL
PostalCode: 605632688
CountryCode: US
TelephoneNumber: 6307180200
FaxNumber: 6307180900
Practice Location
Address1: 6538 CERMAK RD
Address2:  
City: BERWYN
State: IL
PostalCode: 604022899
CountryCode: US
TelephoneNumber: 7087958900
FaxNumber: 7087880772
Other Information
ProviderEnumerationDate: 05/01/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X ILY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home