Provider Demographics
NPI:1467667758
Name:YUNEZ, SALVADOR (MD)
Entity type:Individual
Prefix:DR
First Name:SALVADOR
Middle Name:
Last Name:YUNEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 N DEARBORN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3846
Mailing Address - Country:US
Mailing Address - Phone:312-867-0020
Mailing Address - Fax:312-448-6117
Practice Address - Street 1:712 N DEARBORN ST STE 101
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3846
Practice Address - Country:US
Practice Address - Phone:312-867-0020
Practice Address - Fax:312-448-6117
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036074804174400000X, 207R00000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4932251OtherBLUE CROSS & BLUE SHIELD
ILD16424Medicare UPIN
IL1134207145Medicare ID - Type Unspecified
IL212559Medicare ID - Type Unspecified