Provider Demographics
NPI:1154125144
Name:KUDAIMI, YARAH
Entity type:Individual
Prefix:
First Name:YARAH
Middle Name:
Last Name:KUDAIMI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17200 KIMBARK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-3580
Mailing Address - Country:US
Mailing Address - Phone:708-828-1138
Mailing Address - Fax:
Practice Address - Street 1:17200 KIMBARK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-3580
Practice Address - Country:US
Practice Address - Phone:708-828-1138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program