MEDICARE: DR. SALVADOR ROQUE YUNEZ MD

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	174400000X	Specialist		IL

General Provider Information

NPI Number	:	1750405221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALVADOR ROQUE YUNEZ MD

Provider Business Mailing Address
First Line	:	6745 N CLARK ST
Second Line	:	1 N
City	:	CHICAGO
State	:	IL
Zip	:	60626-3220
Country	:	US
Telephone Number	:	773-743-4958
Fax Number	:	773-743-0150

Provider Business Practice Location Address
First Line	:	6745 N CLARK ST
Second Line	:	1 N
City	:	CHICAGO
State	:	IL
Zip	:	60626-3220
Country	:	US
Telephone Number	:	773-743-4958
Fax Number	:	773-743-0150

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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