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NPI Code Detail

MEDICARE: YESENIA YEPEZ MD

MEDICARE: YESENIA YEPEZ 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
1207Q00000XFamily Medicine Physician036106583IL

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 : 1063459956
Entity Type Code : Individual
Provider Name (Legal Business Name) : YESENIA YEPEZ MD
Provider Business Mailing Address
First Line : 5359 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1450
Country : US
Telephone Number : 773-836-2785
Fax Number : 773-836-7381
Provider Business Practice Location Address
First Line : 5359 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1450
Country : US
Telephone Number : 773-836-2785
Fax Number : 773-836-7381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 09/01/2022

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Directions to “ YESENIA YEPEZ MD” Practice Location

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