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NPI Code Detail

MEDICARE: DR. TITO G YAO MD

MEDICARE:  DR. TITO G YAO  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician036047145IL
2208D00000XGeneral Practice Physician036047145IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043220742
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TITO G YAO MD
Provider Business Mailing Address
First Line : 322 TRINITY LN
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-2561
Country : US
Telephone Number : 773-287-0751
Fax Number : 773-287-0451
Provider Business Practice Location Address
First Line : 5140 W CHICAGO AVE
Second Line : GSK MEDICAL CENTER
City : CHICAGO
State : IL
Zip : 60651-2903
Country : US
Telephone Number : 773-287-0751
Fax Number : 773-287-0451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 09/27/2016

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Directions to “ DR. TITO G YAO MD” Practice Location

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