Provider Demographics
NPI:1356452494
Name:YURO DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:YURO DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROHIT
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RCPT, CRT
Authorized Official - Phone:773-987-8021
Mailing Address - Street 1:720 W. GORDON TERRACE
Mailing Address - Street 2:SUITE 17 L
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2263
Mailing Address - Country:US
Mailing Address - Phone:773-832-0716
Mailing Address - Fax:773-832-0718
Practice Address - Street 1:4947 N WINTHROP AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3607
Practice Address - Country:US
Practice Address - Phone:773-987-8021
Practice Address - Fax:773-832-0718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1940014762278P1004X
2278P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary DiagnosticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========-60613-01Medicaid