Provider Demographics
NPI:1477859171
Name:RUTH M. YANAGI, M.D., S.C.
Entity Type:Organization
Organization Name:RUTH M. YANAGI, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:MIDORI
Authorized Official - Last Name:YANAGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-663-5399
Mailing Address - Street 1:122 S. MICHIGAN AVENUE
Mailing Address - Street 2:SUITE 1317
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-6191
Mailing Address - Country:US
Mailing Address - Phone:312-663-5399
Mailing Address - Fax:312-922-5656
Practice Address - Street 1:122 S. MICHIGAN AVENUE
Practice Address - Street 2:SUITE 1317
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6191
Practice Address - Country:US
Practice Address - Phone:312-663-5399
Practice Address - Fax:312-922-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2011-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL675845972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD15480Medicare UPIN