Provider Demographics
NPI:1518024975
Name:YAABA MEDICAL SERVICES , SC
Entity type:Organization
Organization Name:YAABA MEDICAL SERVICES , SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ATIAH
Authorized Official - Last Name:AKAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-540-4360
Mailing Address - Street 1:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-0720
Mailing Address - Country:US
Mailing Address - Phone:708-540-4360
Mailing Address - Fax:
Practice Address - Street 1:2929 S ELLIS AVE
Practice Address - Street 2:MICHAEL REESE HOSPITAL - SUITE 110 KAPLAN
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3395
Practice Address - Country:US
Practice Address - Phone:312-791-2000
Practice Address - Fax:708-540-4359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RC0000X, 207RI0011X, 207UN0901X
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH47162Medicare UPIN