Provider Demographics
NPI:1972618619
Name:YINGST, GISELA J (MD)
Entity Type:Individual
Prefix:DR
First Name:GISELA
Middle Name:J
Last Name:YINGST
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 1:6410 W 127TH ST 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463
Mailing Address - Country:US
Mailing Address - Phone:708-371-5055
Mailing Address - Fax:708-371-5480
Practice Address - Street 1:6410 W 127TH ST 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463
Practice Address - Country:US
Practice Address - Phone:708-371-5055
Practice Address - Fax:708-371-5480
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
L58597Medicare ID - Type Unspecified
B29061Medicare UPIN
322030Medicare ID - Type Unspecified