Provider Demographics
NPI:1548307234
Name:SNOW, AYELET II (MD)
Entity type:Individual
Prefix:DR
First Name:AYELET
Middle Name:
Last Name:SNOW
Suffix:II
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10640 W 165TH STREET
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467
Mailing Address - Country:US
Mailing Address - Phone:708-364-0261
Mailing Address - Fax:708-364-0269
Practice Address - Street 1:10640 W 165TH STREET
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467
Practice Address - Country:US
Practice Address - Phone:708-364-0261
Practice Address - Fax:708-364-0269
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1227482080S0012X
KY400442080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100040580Medicaid
IN200897140Medicaid
KY7100040580Medicaid