MEDICARE: YURO DIAGNOSTICS, INC

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	2278P1004X	Pulmonary Diagnostics Certified Respiratory Therapist	194001476	IL
2	2278P1004X	Pulmonary Diagnostics Certified Respiratory Therapist

General Provider Information

NPI Number	:	1356452494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YURO DIAGNOSTICS, INC

Provider Business Mailing Address
First Line	:	720 W. GORDON TERRACE
Second Line	:	SUITE 17 L
City	:	CHICAGO
State	:	IL
Zip	:	60613-2263
Country	:	US
Telephone Number	:	773-832-0716
Fax Number	:	773-832-0718

Provider Business Practice Location Address
First Line	:	4947 N WINTHROP AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-3607
Country	:	US
Telephone Number	:	773-987-8021
Fax Number	:	773-832-0718

Authorized Official
Title or Position	:	OWNER / PRESIDENT
Name	:	MR. ROHIT C PATEL
Credential	:	RCPT, CRT
Telephone Number	:	773-987-8021

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/02/2015

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