Individual provider Active NPI

Samuel Manuel Yunez, M.D.

  • Family Medicine Physician
  • Elmhurst, IL
National Provider Identifier
1376685636
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036075764 Issued in IL
Practice address
1200 S York St Ste 4260
Elmhurst, IL 60126-5632
Phone
(708) 450-0055
Fax
(708) 450-0288
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036075764 IL Primary

Addresses

Primary practice location

1200 S York St Ste 4260
Elmhurst, IL 60126-5632

Mailing address

1200 S York St Ste 4260
Elmhurst, IL 60126-5632
Phone (708) 450-0055

Other practice location 1

7411 Lake St Ste 2210
River Forest, IL 60305-1886
Phone (708) 450-0055

Other identifiers 1

IdentifierTypeStateIssuer
0360757641MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080109000698 IL Practitioner - Family Practice 7810880275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7411 Lake St
Suite 2210
River Forest, IL 60305-1886
Phone (708) 450-0055

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliates in Primary Care,S.C. Family Medicine CurrentSince Jan 1, 1987 Accepting new patients
Women's Doc of Elgin, S. C. Family Medicine Past Accepting new patients
Your Doc of Melrose Park Past Accepting new patients

Locations

1200 S York St
Ste 4260
Elmhurst, IL 60126
Phone (331) 221-6135

1111 Superior St
Ste 306
Melrose Park, IL 60160
Phone (708) 450-0055

1730 Park St
Ste 101
Naperville, IL 60563
Phone (630) 718-0200

7411 Lake St
Ste 2210
River Forest, IL 60305
Phone (708) 366-8200

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1376685636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST STE 4260",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265632",
            "telephone_number": "708-450-0055",
            "fax_number": "708-450-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST STE 4260",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265632",
            "telephone_number": "708-450-0055",
            "fax_number": "708-450-0288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7411 Lake St Ste 2210",
            "address_purpose": "LOCATION",
            "city": "River Forest",
            "state": "IL",
            "postal_code": "603051886",
            "country_code": "US",
            "telephone_number": "708-450-0055",
            "fax_number": "708-450-0288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUNEZ",
        "first_name": "SAMUEL",
        "middle_name": "MANUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036075764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360757641",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.