Individual
ALEX A YARBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3101 FIELDS SOUTH DR, CHAMPAIGN, IL 61822-3743
(217) 366-6162
(217) 366-5642
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-6162
(217) 366-5642
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036116115
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203979019
MEDICARE PTAN
IL
Enumeration date
08/14/2006
Last updated
01/07/2025
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