MEDICARE: MRS. ELAINE S YILDIZ PA-C

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
1	363A00000X	Physician Assistant	085-000896	IL

General Provider Information

NPI Number	:	1295876563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELAINE S YILDIZ PA-C

Provider Business Mailing Address
First Line	:	3001 N. GREENBAY ROAD
Second Line	:
City	:	N. CHICAGO
State	:	IL
Zip	:	60064
Country	:	US
Telephone Number	:	847-688-1900
Fax Number	:	224-610-2913

Provider Business Practice Location Address
First Line	:	3001 N. GREENBAY ROAD
Second Line	:
City	:	N. CHICAGO
State	:	IL
Zip	:	60064
Country	:	US
Telephone Number	:	847-688-1900
Fax Number	:	224-610-2913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	01/28/2010

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