Provider Demographics
NPI:1982861316
Name:Y E AKL MD DC
Entity type:Organization
Organization Name:Y E AKL MD DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSSEF
Authorized Official - Middle Name:E
Authorized Official - Last Name:AKL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-783-0044
Mailing Address - Street 1:550 E BOUGHTON RD SUITE 110
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440
Mailing Address - Country:US
Mailing Address - Phone:630-783-0044
Mailing Address - Fax:630-783-1961
Practice Address - Street 1:550 E BOUGHTON RD SUITE 110
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440
Practice Address - Country:US
Practice Address - Phone:630-783-0044
Practice Address - Fax:630-783-1961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:Y E AKL MD SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036059757208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036059757Medicaid