MEDICARE: RONALD F YAKE MD SC

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	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1356520795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD F YAKE MD SC

Provider Business Mailing Address
First Line	:	1021 N MULFORD RD
Second Line	:	SUITE L3
City	:	ROCKFORD
State	:	IL
Zip	:	61107
Country	:	US
Telephone Number	:	815-395-1991
Fax Number	:	815-395-1994

Provider Business Practice Location Address
First Line	:	1021 N MULFORD RD
Second Line	:	SUITE L3
City	:	ROCKFORD
State	:	IL
Zip	:	61107
Country	:	US
Telephone Number	:	815-395-1991
Fax Number	:	815-395-1994

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	RONALD F YAKE
Credential	:	MD
Telephone Number	:	815-395-1991

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	11/02/2007

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