Provider Demographics
NPI:1558356253
Name:YONOVER, PAUL M (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:YONOVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1011 W WELLINGTON AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4325
Mailing Address - Country:US
Mailing Address - Phone:773-281-1011
Mailing Address - Fax:773-281-1029
Practice Address - Street 1:1011 W WELLINGTON AVE
Practice Address - Street 2:STE 200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4325
Practice Address - Country:US
Practice Address - Phone:773-281-1011
Practice Address - Fax:773-281-1029
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036101015208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036101015Medicaid
ILK05361OtherCHGO PROSTATE CTR PIN
IL610332000OtherWORKERS COMPENSATION
P00661908OtherRAILROAD MEDICARE
1635877OtherBCBS
ILK05361OtherCHGO PROSTATE CTR PIN
ILH78468Medicare UPIN