Individual
MRS. RUBY GUZMAN YAMAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5086 N ELSTON AVE, CHICAGO, IL 60630-2427
(773) 725-0200
Mailing address
5415 N SHERIDAN RD, APT 911, CHICAGO, IL 60640-1969
(708) 408-1324
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.003541
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085.003541
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
09/10/2009
Last updated
03/18/2016
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