Provider Demographics
NPI:1902143605
Name:ALI, YASEEN (MD)
Entity type:Individual
Prefix:DR
First Name:YASEEN
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ELM CREEK DR
Mailing Address - Street 2:SUITE NUMBER 211
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5609
Mailing Address - Country:US
Mailing Address - Phone:630-812-8459
Mailing Address - Fax:
Practice Address - Street 1:5 ELM CREEK DR
Practice Address - Street 2:SUITE 211
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5609
Practice Address - Country:US
Practice Address - Phone:312-721-2000
Practice Address - Fax:331-684-0098
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036131430207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist