Provider Demographics
NPI:1790764371
Name:YOKANA, MYRIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRIAM
Middle Name:
Last Name:YOKANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 MANNHEIM RD
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-2265
Mailing Address - Country:US
Mailing Address - Phone:847-451-9244
Mailing Address - Fax:847-451-9413
Practice Address - Street 1:2930 MANNHEIM RD
Practice Address - Street 2:SUITE # 2
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2265
Practice Address - Country:US
Practice Address - Phone:847-451-9244
Practice Address - Fax:847-451-9413
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-108888207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108888Medicaid
IL036108888Medicaid