MEDICARE: VEIN CLINICS OF CHICAGO LLC

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	2086S0129X	Vascular Surgery Physician

General Provider Information

NPI Number	:	1386904621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEIN CLINICS OF CHICAGO LLC

Provider Business Mailing Address
First Line	:	PO BOX 451
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60065-0451
Country	:	US
Telephone Number	:	847-593-8460
Fax Number	:	888-621-3330

Provider Business Practice Location Address
First Line	:	3927 W BELMONT AVE
Second Line	:	STE 103
City	:	CHICAGO
State	:	IL
Zip	:	60618-5170
Country	:	US
Telephone Number	:	847-593-8460
Fax Number	:	847-593-8604

Authorized Official
Title or Position	:	OWNER
Name	:	DR. YAN KATSNELSON
Credential	:	MD
Telephone Number	:	847-593-8460

Provider Enumeration Date	:	05/21/2012
Last Update Date	:	05/24/2022

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