Provider Demographics
NPI:1225047194
Name:GREG YAHIRO MD LTD
Entity Type:Organization
Organization Name:GREG YAHIRO MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:YAHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-434-9700
Mailing Address - Street 1:3825 HIGHLAND AVE
Mailing Address - Street 2:SUITE 3F
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1552
Mailing Address - Country:US
Mailing Address - Phone:630-434-9700
Mailing Address - Fax:
Practice Address - Street 1:3825 HIGHLAND AVE
Practice Address - Street 2:SUITE 3F
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1552
Practice Address - Country:US
Practice Address - Phone:630-434-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDG1600OtherRAILROAD MEDICARE
=========OtherEIN
IL213829Medicare PIN