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General NPI Number Information
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NPI Number | 1346308681
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Entity Type | Individual
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Provider Name | JONATHAN Y YAHAV DDS PC
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 845 N MICHIGAN AVE WATER TOWER PLACE SUITE 976W
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 312-440-4909
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Fax | 312-440-0111
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Provider Business Mailing Address
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Address Line | 845 N MICHIGAN AVE WATER TOWER PLACE SUITE 976W
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 312-440-4909
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Fax | 312-440-0111
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0190211611
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License Number State | IL
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