Provider Demographics
NPI:1982745931
Name:TRABADO, MARCELO YAP (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCELO
Middle Name:YAP
Last Name:TRABADO
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 1:1608 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60636-3316
Mailing Address - Country:US
Mailing Address - Phone:773-471-0017
Mailing Address - Fax:773-471-1232
Practice Address - Street 1:1608 W 69TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60636-3316
Practice Address - Country:US
Practice Address - Phone:773-471-0017
Practice Address - Fax:773-471-1232
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL473880Medicare ID - Type UnspecifiedMEDICARE
ILD12643Medicare UPIN