Individual
DR. YANNEK ISAAC LEIDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
1855 W TAYLOR ST # MC648, UIC DEPT OF OPHTHALMOLOGY AND VISUAL SCIENCES, CHICAGO, IL 60612-7242
(312) 413-4999
Mailing address
1855 W TAYLOR ST # MC648, UIC DEPT OF OPHTHALMOLOGY AND VISUAL SCIENCES, CHICAGO, IL 60612-7242
(312) 413-4999
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
224712
MA
207W00000X
Ophthalmology Physician
Primary
235488
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962590232
BLUE CROSS BLUE SHIELD
MA
05
—
30209380
—
NH
Enumeration date
12/20/2006
Last updated
08/30/2010
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