Healthcare Provider Details

I. General information

NPI: 1154638872
Provider Name (Legal Business Name): YAHAIRA ESPADA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5341 W CERMAK RD
CICERO IL
60804-2817
US

IV. Provider business mailing address

26 S CORIA ST SUITE B-2
BROWNSVILLE TX
78520-7565
US

V. Phone/Fax

Practice location:
  • Phone: 708-656-6430
  • Fax:
Mailing address:
  • Phone: 956-621-0587
  • Fax: 956-621-0595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberN8394
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA08832300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036.160671
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: