Provider Demographics
NPI:1073884722
Name:YANASE, MEGUMI (MSC,DVM)
Entity Type:Individual
Prefix:MS
First Name:MEGUMI
Middle Name:
Last Name:YANASE
Suffix:
Gender:F
Credentials:MSC,DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DICKINSON CT
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1009
Mailing Address - Country:US
Mailing Address - Phone:847-984-2378
Mailing Address - Fax:847-984-2378
Practice Address - Street 1:109 DICKINSON CT
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1009
Practice Address - Country:US
Practice Address - Phone:847-984-2378
Practice Address - Fax:847-984-2378
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter