Provider Demographics
NPI:1245597640
Name:YASSIN, ENAS RASHID (MD,BSN, NP-C)
Entity Type:Individual
Prefix:DR
First Name:ENAS
Middle Name:RASHID
Last Name:YASSIN
Suffix:
Gender:F
Credentials:MD,BSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5020 N ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-3411
Mailing Address - Country:US
Mailing Address - Phone:618-222-8900
Mailing Address - Fax:
Practice Address - Street 1:5020 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-3411
Practice Address - Country:US
Practice Address - Phone:618-222-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023013363LA2200X
MO2020032921363LG0600X
VA0101275619207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101275619OtherVIRGINIA PHYSICIAN LICENSE NUMBER