Healthcare Provider Details

I. General information

NPI: 1467667758
Provider Name (Legal Business Name): SALVADOR YUNEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 N DEARBORN ST STE 101
CHICAGO IL
60654-3846
US

IV. Provider business mailing address

712 N DEARBORN ST STE 101
CHICAGO IL
60654-3846
US

V. Phone/Fax

Practice location:
  • Phone: 312-867-0020
  • Fax: 312-448-6117
Mailing address:
  • Phone: 312-867-0020
  • Fax: 312-448-6117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number036074804
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036074804
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number036074804
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: