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Individual

DR. TITO G YAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5140 W CHICAGO AVE, GSK MEDICAL CENTER, CHICAGO, IL 60651-2903
(773) 287-0751
(773) 287-0451
Mailing address
322 TRINITY LN, OAK BROOK, IL 60523-2561
(773) 287-0751
(773) 287-0451

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036047145
IL
208D00000X
General Practice Physician
Primary
036047145
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036047145
IL
Enumeration date
08/08/2006
Last updated
09/27/2016
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