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Individual

YOGESH S JETHAVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1700 LUTHER LN STE 1220, PARK RIDGE, IL 60068-1270
(847) 723-4400
(847) 723-4410
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01083803A
IN
207RH0000X
Hematology (Internal Medicine) Physician
01083803A
IN
207RH0000X
Hematology (Internal Medicine) Physician
Primary
036-173805
IL
207RH0003X
Hematology & Oncology Physician
E-7937
AR
207RH0003X
Hematology & Oncology Physician
MD-46051
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300044868
IN
Enumeration date
08/02/2013
Last updated
05/02/2025
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