Provider Demographics
NPI:1760744031
Name:AKHRAS, YAMEN (DDS)
Entity Type:Individual
Prefix:
First Name:YAMEN
Middle Name:
Last Name:AKHRAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9641 W 153RD ST STE 41
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-4603
Mailing Address - Country:US
Mailing Address - Phone:612-876-7886
Mailing Address - Fax:
Practice Address - Street 1:9641 W 153RD ST STE 41
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4603
Practice Address - Country:US
Practice Address - Phone:612-876-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-029051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist