Individual
DR. KENNETH YOKOSAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2020 OGDEN AVENUE, SUITE 330, AURORA, IL 60504
(630) 978-4850
(630) 978-6865
Mailing address
2020 OGDEN AVE STE 330, AURORA, IL 60504-5897
(630) 978-4850
(630) 978-6865
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036134722
IL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
036134722
IL
207QA0505X
Adult Medicine Physician
036134722
IL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
036134722
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036134722
—
IL
01
—
638460
MEDICARE GROUP PTAN
IL
Enumeration date
06/05/2006
Last updated
07/21/2020
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