Young, Debra E

Young, Debra E is an individual health care provider with primary practice located at 2266 N Lincoln Ave , Chicago IL 60614-3718. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Young, Debra E can be contacted via phone (773) 871-3338.

Contact Information

Primary practice address
2266 N Lincoln Ave Chicago IL 60614-3718
Phone: (773) 871-3338
Fax: (773) 295-2210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016-003073 Illinois

Profile Details

NPI number 1689670051
LBN Legal business name Young, Debra E
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Jun 9th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689670051 NPPES
Illinois Other 208638 MEDICARE GROUP #
Illinois MEDICAID 03-0403187 MEDICARE GROUP #
Illinois MEDICAID 200844930A MEDICARE GROUP #
Illinois Other 480034943 MEDICARE GROUP #
Illinois Other 4791120001 MEDICARE GROUP #

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