Healthcare Provider Details

I. General information

NPI: 1366636334
Provider Name (Legal Business Name): YASIR A MEKKI MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1795 N BUTTERFIELD RD STE 101
LIBERTYVILLE IL
60048-1212
US

IV. Provider business mailing address

1795 N BUTTERFIELD RD STE 101
LIBERTYVILLE IL
60048-1212
US

V. Phone/Fax

Practice location:
  • Phone: 847-336-8472
  • Fax: 847-360-2229
Mailing address:
  • Phone: 847-336-8472
  • Fax: 847-360-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036098235
License Number StateIL

VIII. Authorized Official

Name: DR. YASIR AKRAM MEKKI
Title or Position: PRESIDENT
Credential: MD
Phone: 847-336-8472