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General NPI Number Information
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NPI Number | 1063159119
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Entity Type | Organization
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Legal Business Name | YELENA BOUMENDJEL, DPM, LLC
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 1025 W WISE RD STE 100
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City | SCHAUMBURG
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State | IL
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Zip | 60193-3746
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Country | US
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Telephone | 224-653-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 W WISE RD STE 100
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City | SCHAUMBURG
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State | IL
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Zip | 60193-3746
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Country | US
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Telephone | 224-653-2260
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Fax |
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Authorized Official
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Title or Position | DPM
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Name | YELENA BOUMENDJEL
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Credential |
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Telephone | 224-653-9287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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