Provider Demographics
NPI:1144487331
Name:YOUNIS, AMJAD A (MD)
Entity type:Individual
Prefix:DR
First Name:AMJAD
Middle Name:A
Last Name:YOUNIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000-2D
Mailing Address - Street 2:TRAPPERS COVE TRAIL
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910
Mailing Address - Country:US
Mailing Address - Phone:210-255-0875
Mailing Address - Fax:
Practice Address - Street 1:1740 W TAYLOR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:866-600-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program