Provider Demographics
NPI:1215960240
Name:YONKEE, JAMES M (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:YONKEE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 CIRCLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108
Mailing Address - Country:US
Mailing Address - Phone:630-673-4996
Mailing Address - Fax:
Practice Address - Street 1:1691 SOUTH ROUTE 59
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103
Practice Address - Country:US
Practice Address - Phone:630-372-2883
Practice Address - Fax:630-372-2886
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046008757152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01342601OtherRAIL ROAD MEDICARE
ILF400126949Medicare PIN
ILF400126950Medicare PIN
ILF400126947Medicare PIN
ILP01342601OtherRAIL ROAD MEDICARE
ILIL7712001Medicare PIN