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NPI Code Detail

MEDICARE: YASMEEN ANSARI MD

MEDICARE: YASMEEN ANSARI 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
1207Q00000XFamily Medicine Physician036.122925IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1400480OTHERILMEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number : 1750597811
Entity Type Code : Individual
Provider Name (Legal Business Name) : YASMEEN ANSARI MD
Provider Business Mailing Address
First Line : 199 S ADDISON RD
Second Line : SUITE 108
City : WOOD DALE
State : IL
Zip : 60191-1929
Country : US
Telephone Number : 630-616-7223
Fax Number : 630-616-7224
Provider Business Practice Location Address
First Line : 14290 S LA GRANGE RD
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-2023
Country : US
Telephone Number : 888-824-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/23/2024

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