Active NPI
Edgardo L Yordan Jr., M.D.
- Gynecologic Oncology Physician
- Chicago, IL
National Provider Identifier
1184609158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecologic Oncology Physician
- License
- 036061392
- Practice address
- 1725 W Harrison St
Suite 1010
Chicago, IL 60612-3841 - Phone
- (312) 942-6300
- Fax
- (312) 942-6301
- NPI assigned
- Dec 13, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Gynecologic Oncology Physician | 207VX0201X | 036061392 | IL | Primary |
Addresses
Primary practice location
1725 W Harrison St
Suite 1010
Chicago, IL 60612-3841
Mailing address
1725 W Harrison St
Suite 1010
Chicago, IL 60612-3841
Phone (312) 942-6300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01621679 | Other | IL | BCBS OF IL |
| 036061392 / 02 | Medicaid | IL |
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Podiatry Services LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Foot & Ankle Surgery Podiatrist
- Oak Park, IL
- NPI 1679693865
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316736000000",
"number": "1184609158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 W HARRISON ST",
"address_2": "SUITE 1010",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-942-6300",
"fax_number": "312-942-6301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 W HARRISON ST",
"address_2": "SUITE 1010",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-942-6300",
"fax_number": "312-942-6301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YORDAN",
"first_name": "EDGARDO",
"middle_name": "L",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-13",
"last_updated": "2011-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0201X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": "IL",
"license": "036061392",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF IL",
"identifier": "01621679",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036061392 / 02",
"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 Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.