Provider Demographics
NPI:1316040579
Name:YORATH, MARTIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:YORATH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 W PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-3043
Mailing Address - Country:US
Mailing Address - Phone:847-578-8432
Mailing Address - Fax:
Practice Address - Street 1:4026 W PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-3043
Practice Address - Country:US
Practice Address - Phone:847-578-8432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist