MEDICARE: KENTARO YOSHIKAWA

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	204F00000X	Transplant Surgery Physician	125081072	IL

General Provider Information

NPI Number	:	1700508025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENTARO YOSHIKAWA

Provider Business Mailing Address
First Line	:	765 W ADAMS ST APT 1611
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60661-3511
Country	:	US
Telephone Number	:	773-584-8859
Fax Number	:

Provider Business Practice Location Address
First Line	:	765 W ADAMS ST APT 1611
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60661-3511
Country	:	US
Telephone Number	:	773-584-8859
Fax Number	:

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

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	09/13/2022

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Directions to “ KENTARO YOSHIKAWA ” Practice Location

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