Individual
DR. AMY KIM YETASOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 W PARK ST, GRADUATE MEDICAL EDUCATION DEPARTMENT, URBANA, IL 61801-2500
(217) 326-1293
Mailing address
2114 W DIVISION ST, #3, CHICAGO, IL 60622-3035
(213) 268-5421
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125063845
IL
Other
Enumeration date
02/07/2014
Last updated
02/07/2014
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