Provider Demographics
NPI:1760581052
Name:YARSHEN FAMILY MEDICINE SC
Entity Type:Organization
Organization Name:YARSHEN FAMILY MEDICINE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:YARSHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:815-577-0300
Mailing Address - Street 1:24600 W. 127TH ST.
Mailing Address - Street 2:UNITE 2, SUITE 125
Mailing Address - City:PLAINFIIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585
Mailing Address - Country:US
Mailing Address - Phone:815-577-0300
Mailing Address - Fax:815-577-0317
Practice Address - Street 1:24600 W. 127TH STREET
Practice Address - Street 2:UNITE 2 SUITE 125
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585
Practice Address - Country:US
Practice Address - Phone:815-577-0300
Practice Address - Fax:815-577-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty