Anwar Yamini Sr., PUBLIC HEALTH

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

14-4610 Issued in IL

Practice address

15520 Rose Dr
South Holland, IL 60473-1337

Phone

(708) 432-8445

NPI assigned

May 29, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medco Physicians Unlimited Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Holland, IL
  • NPI 1255543344
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1114541893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16260 LOUIS AVE UNIT 1546",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604735285",
            "telephone_number": "708-724-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15520 ROSE DR",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731337",
            "telephone_number": "708-432-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMINI",
        "first_name": "ANWAR",
        "name_suffix": "Sr.",
        "credential": "PUBLIC HEALTH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "14-4610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Antoinette Wright- Sturgess
• Sabina Wytrwal
• Xcellent Investments
• Xtra Mile Transport Nemt LLC
• Asabi S Yakini
• Anisah Yassin, DC
• Ginnette Yonkman
• Shelley A Young, DDS
• Waseem Zaid Alkilani, MD
• Carla Maria Zambrano

• Community/Behavioral Health Agency in South Holland, IL
• Providers in South Holland, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.