Healthcare Provider Details

I. General information

NPI: 1043531353
Provider Name (Legal Business Name): YVONNE I CLAFLIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST GALTER 3-150
CHICAGO IL
60611-2908
US

IV. Provider business mailing address

251 E HURON ST GALTER 3-150
CHICAGO IL
60611-2908
US

V. Phone/Fax

Practice location:
  • Phone: 312-503-7975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125057931
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: