Provider Demographics
NPI:1912909615
Name:RYABOV, YAKOV (MD)
Entity type:Individual
Prefix:
First Name:YAKOV
Middle Name:
Last Name:RYABOV
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 1:3230 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-6905
Mailing Address - Country:US
Mailing Address - Phone:847-419-1900
Mailing Address - Fax:847-419-1964
Practice Address - Street 1:201 E STRONG ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-2979
Practice Address - Country:US
Practice Address - Phone:847-419-1900
Practice Address - Fax:847-419-1964
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036089785207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine