Basic Information
| Provider Information | |||||||||
| NPI: | 1518024975 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YAABA MEDICAL SERVICES , SC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 720 | ||||||||
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| City: | HILLSIDE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601620720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7085404360 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2929 S ELLIS AVE | ||||||||
| Address2: | MICHAEL REESE HOSPITAL - SUITE 110 KAPLAN | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606163395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127912000 | ||||||||
| FaxNumber: | 7085404359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2007 | ||||||||
| LastUpdateDate: | 08/24/2007 | ||||||||
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| AuthorizedOfficialLastName: | AKAMAH | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | ATIAH | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7085404360 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207UN0901X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | 207R00000X | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.