Individual
BRYAN YANAGA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1211 W ROOSEVELT RD, MAYWOOD, IL 60153
(708) 531-7900
(708) 531-5201
Mailing address
2160 S 1ST AVE, 101-1740 LOYOLA UNIVERSITY MEDICAL CENTER, MAYWOOD, IL 60153
(708) 216-9000
(708) 216-9033
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36084003
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36084003
—
IL
Enumeration date
02/15/2006
Last updated
07/08/2007
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