Provider Demographics
NPI:1972833663
Name:YARKONY REHABILITATION ASSOCIATES LTD
Entity Type:Organization
Organization Name:YARKONY REHABILITATION ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YARKONY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-468-1511
Mailing Address - Street 1:1975 LIN LOR LN
Mailing Address - Street 2:SUITE 195
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4902
Mailing Address - Country:US
Mailing Address - Phone:847-468-1511
Mailing Address - Fax:
Practice Address - Street 1:1975 LIN LOR LN
Practice Address - Street 2:SUITE 195
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4902
Practice Address - Country:US
Practice Address - Phone:847-468-1511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-03
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-058973208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036058973Medicaid
IL036058973Medicaid