Provider Demographics
NPI:1124036157
Name:FELDMAN, ANSLEY YELLEN (MD)
Entity Type:Individual
Prefix:
First Name:ANSLEY
Middle Name:YELLEN
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANSLEY
Other - Middle Name:LYN
Other - Last Name:YELLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:849 SUMAC RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035
Mailing Address - Country:US
Mailing Address - Phone:847-607-0841
Mailing Address - Fax:847-607-0840
Practice Address - Street 1:4113 DUNDEE ROAD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-272-1005
Practice Address - Fax:847-272-1136
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036112503208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics