Provider Demographics
NPI:1063411346
Name:HENSEL, XIAOYING GUO (MD)
Entity type:Individual
Prefix:
First Name:XIAOYING
Middle Name:GUO
Last Name:HENSEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:XIAOYING
Other - Middle Name:
Other - Last Name:GUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1515 SHERIDAN RD STE 31A
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1828
Mailing Address - Country:US
Mailing Address - Phone:847-920-2200
Mailing Address - Fax:847-920-2201
Practice Address - Street 1:1515 SHERIDAN RD STE 31A
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091
Practice Address - Country:US
Practice Address - Phone:847-920-2200
Practice Address - Fax:847-920-2201
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1627087OtherBLUECROSS/BLUESHIELD
110214961OtherPALMETTO GBA (RAILROADMED
IL336059176OtherIL SUBSTANCE LICENSE
IL036098890Medicaid
IL036098890OtherIL STATE LICENSE
BG6126761OtherFEDERAL DEA NUMBER
IL036098890OtherIL STATE LICENSE
IL036098890Medicaid
IL336059176OtherIL SUBSTANCE LICENSE