Individual
DEBRA E YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2266 N LINCOLN AVE, CHICAGO, IL 60614-3718
(773) 871-3338
(773) 295-2210
Mailing address
2752 N SOUTHPORT AVE, CHICAGO, IL 60614-1230
(773) 327-0006
(773) 295-2210
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-003073
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03-0403187
—
IL
05
—
200844930A
—
IN
01
—
208638
MEDICARE GROUP #
IL
01
—
4791120001
DMERC
IN
01
—
480034943
RAILROAD MEDICARE #
IL
Enumeration date
06/21/2005
Last updated
06/09/2016
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