Provider Demographics
NPI:1912114497
Name:YARSHEN, CYNTHIA M (DO)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:YARSHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16151 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-0863
Mailing Address - Country:US
Mailing Address - Phone:815-838-2888
Mailing Address - Fax:815-838-0222
Practice Address - Street 1:16151 WEBER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-0863
Practice Address - Country:US
Practice Address - Phone:815-838-2888
Practice Address - Fax:815-838-0222
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036119509207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1912114497Medicaid