Provider Demographics
NPI:1417310244
Name:ALMALLAH, YAHIA ZAKI (MD)
Entity Type:Individual
Prefix:
First Name:YAHIA
Middle Name:ZAKI
Last Name:ALMALLAH
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 1:820 S WOOD ST
Mailing Address - Street 2:CSN SUIT 515 M/C 955
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:312-996-9330
Mailing Address - Fax:312-413-0495
Practice Address - Street 1:820 S WOOD ST
Practice Address - Street 2:CSN SUIT 515 M/C 955
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4325
Practice Address - Country:US
Practice Address - Phone:312-996-9330
Practice Address - Fax:312-413-0495
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL113.000072208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology