MEDICARE: DR. CHILAKAMARRI YESHWANT MD

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
1	207RH0003X	Hematology & Oncology Physician	036048906	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518954890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHILAKAMARRI YESHWANT MD

Provider Business Mailing Address
First Line	:	PO BOX 25070
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-2150
Country	:	US
Telephone Number	:	847-585-7000
Fax Number	:	847-240-0622

Provider Business Practice Location Address
First Line	:	1710 N RANDALL RD
Second Line	:	STE 300
City	:	ELGIN
State	:	IL
Zip	:	60123-9400
Country	:	US
Telephone Number	:	847-931-0909
Fax Number	:	847-931-0939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	04/01/2014

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