| Yictory Health Inc | |
|
201 Park Pl Ste 2 Bourbonnais IL 60914-1883 | |
| (708) 288-9536 | |
| Not Available |
| Full Name | Yictory Health Inc |
|---|---|
| Speciality | General Practice |
| Location | 201 Park Pl Ste 2, Bourbonnais, Illinois |
| Authorized Official Name and Position | Ming Xu (CEO) |
| Authorized Official Contact | 7082889536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yictory Health Inc 1106 Midwest Club Pkwy Oak Brook IL 60523-2535 Ph: () - | Yictory Health Inc 201 Park Pl Ste 2 Bourbonnais IL 60914-1883 Ph: (708) 288-9536 |
| NPI Number | 1548930779 |
|---|---|
| Provider Enumeration Date | 09/18/2021 |
| Last Update Date | 01/19/2022 |
| Medicare PECOS PAC ID | 6800287012 |
|---|---|
| Medicare Enrollment ID | O20221003000394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548930779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Yan Jiang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265812747 PECOS PAC ID: 9133498058 Enrollment ID: I20211011000627 |
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