Provider Demographics
NPI:1275520959
Name:KUMAR, YOGINDER (MD)
Entity Type:Individual
Prefix:
First Name:YOGINDER
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 WASHINGTON ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-4983
Mailing Address - Country:US
Mailing Address - Phone:847-244-6800
Mailing Address - Fax:847-244-9538
Practice Address - Street 1:2504 WASHINGTON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-4983
Practice Address - Country:US
Practice Address - Phone:847-244-6800
Practice Address - Fax:847-244-9538
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070187207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036070187Medicaid
770260Medicare ID - Type Unspecified
D16426Medicare UPIN