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NPI Code Detail

MEDICARE: YSM MEDICAL GROUP CENTER

MEDICARE: YSM MEDICAL GROUP CENTER
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
1207R00000XInternal Medicine PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101633361OTHERILBCBS PROVIDER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588743504
Entity Type Code : Organization
Provider Name (Legal Business Name) : YSM MEDICAL GROUP CENTER
Provider Business Mailing Address
First Line : 653 N KINGSBURY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60610-7069
Country : US
Telephone Number : 773-577-0147
Fax Number :
Provider Business Practice Location Address
First Line : 4733 N DAMEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60625-1442
Country : US
Telephone Number : 773-878-6060
Fax Number :
Authorized Official
Title or Position : INTERNAL MEDICINE
Name : DR. CESAR A MORALES
Credential : MD
Telephone Number : 773-878-6060
Provider Enumeration Date : 11/02/2006
Last Update Date : 08/22/2020

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Directions to “YSM MEDICAL GROUP CENTER ” Practice Location

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