Provider Demographics
NPI:1184698060
Name:YAO, KATHARINE (MD)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:YAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE.
Mailing Address - Street 2:NORTHSHORE UNIVERSITY HEALTH SYSTEM
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1327
Mailing Address - Fax:847-733-3695
Practice Address - Street 1:2650 RIDGE AVE
Practice Address - Street 2:NORTHSHORE UNIVERSITY HEALTH SYSTEM
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1718
Practice Address - Country:US
Practice Address - Phone:847-570-1327
Practice Address - Fax:847-733-3695
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36095007208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H49364Medicare UPIN