Provider Demographics
NPI:1710265970
Name:GIRGIS, YOUSRY (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUSRY
Middle Name:
Last Name:GIRGIS
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 1:6455 S PULASKI RD # A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-5148
Mailing Address - Country:US
Mailing Address - Phone:773-735-3456
Mailing Address - Fax:773-735-3279
Practice Address - Street 1:715 WALNUT DR
Practice Address - Street 2:APT 210
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4764
Practice Address - Country:US
Practice Address - Phone:331-425-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125055664207R00000X
IL036.129213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine