Active NPI
Ruby Guzman Yamamoto, PA-C
- Medical Physician Assistant
- Chicago, IL
National Provider Identifier
1154654952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 085.003541
- Practice address
- 5086 N Elston Ave
Chicago, IL 60630-2427 - Phone
- (773) 725-0200
- NPI assigned
- Sep 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085.003541 | IL | Primary |
Addresses
Primary practice location
5086 N Elston Ave
Chicago, IL 60630-2427
Mailing address
5415 N Sheridan Rd
Apt 911
Chicago, IL 60640-1969
Phone (708) 408-1324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085.003541 | Other | IL | ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.003541 | IL | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458259200000",
"number": "1154654952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5415 N SHERIDAN RD",
"address_2": "APT 911",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606401969",
"telephone_number": "708-408-1324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5086 N ELSTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606302427",
"telephone_number": "773-725-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMAMOTO",
"first_name": "RUBY",
"middle_name": "GUZMAN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-10",
"last_updated": "2016-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085.003541",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
"identifier": "085.003541",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.