Provider Demographics
NPI:1255318259
Name:WANG HUNG, LILY N (DPT MHA MCS CFCE)
Entity type:Individual
Prefix:MRS
First Name:LILY
Middle Name:N
Last Name:WANG HUNG
Suffix:
Gender:F
Credentials:DPT MHA MCS CFCE
Other - Prefix:MRS
Other - First Name:LILY
Other - Middle Name:N
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT MHA
Mailing Address - Street 1:2001 BUTTERFIELD RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1211
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:
Practice Address - Street 1:1245 MAIN ST STE 230
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-2269
Practice Address - Country:US
Practice Address - Phone:512-400-4437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFY045208100000X
CAPT153682251G0304X
CAPT015368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT153680OtherBLUE SHIELD
CA694030OtherUNITED HEALTH CARE
CA10802140OtherBLUE CROSS ADVANTAGE SENIOR PLAN
CA5662490OtherFIRST HEALTH