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NPI Code Detail

MEDICARE: MR. EDGARDO L YORDAN JR. M.D.

MEDICARE:  MR. EDGARDO L YORDAN JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VX0201XGynecologic Oncology Physician036061392IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101621679OTHERILBCBS OF IL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184609158
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDGARDO L YORDAN JR. M.D.
Provider Business Mailing Address
First Line : 1725 W HARRISON ST
Second Line : SUITE 1010
City : CHICAGO
State : IL
Zip : 60612-3841
Country : US
Telephone Number : 312-942-6300
Fax Number : 312-942-6301
Provider Business Practice Location Address
First Line : 1725 W HARRISON ST
Second Line : SUITE 1010
City : CHICAGO
State : IL
Zip : 60612-3841
Country : US
Telephone Number : 312-942-6300
Fax Number : 312-942-6301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 09/23/2011

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