Provider Demographics
NPI:1912124538
Name:YEN, JULIA LAI-TEH (MD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:LAI-TEH
Last Name:YEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:LAI-TEH
Other - Last Name:YEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1274 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1638
Mailing Address - Country:US
Mailing Address - Phone:847-446-3853
Mailing Address - Fax:
Practice Address - Street 1:625 N MICHIGAN AVE STE 1910
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3178
Practice Address - Country:US
Practice Address - Phone:312-951-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360726822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry