Active NPI
Urooj Yazdani, MD, M.ED.
- Child & Adolescent Psychiatry Physician
- Chicago, IL
National Provider Identifier
1447749569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- Y78954689087
- Practice address
- 5841 S Maryland Ave
Chicago, IL 60637-1443 - Phone
- (773) 702-3858
- NPI assigned
- May 3, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | Y78954689087 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Mailing address
623 Brummel St Apt 2
Evanston, IL 60202-3907
Other practice location 1
530 S Jackson St
Louisville, KY 40202-1675
Phone (202) 621-4354
Other practice location 2
1622 Willow Rd Ste 200
Northfield, IL 60093-3450
Phone (847) 853-0234
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Y78954689087 | IL | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Services Corporation of Southern Illinois Inc. | Current | Accepting new patients | |
| Afg Guidance Center LTD | Child & Adolescent Psychiatry | Past | Accepting new patients |
Locations
400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221
2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Mount Vernon, IL
- NPI 1831101807
-
- Child & Adolescent Psychiatry Physician
- Evanston, IL
- NPI 1295985786
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682035200000",
"number": "1447749569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 BRUMMEL ST APT 2",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602023907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371443",
"telephone_number": "773-702-3858"
}
],
"practiceLocations": [
{
"address_1": "530 S Jackson St",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402021675",
"country_code": "US",
"telephone_number": "202-621-4354",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1622 Willow Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Northfield",
"state": "IL",
"postal_code": "600933450",
"country_code": "US",
"telephone_number": "847-853-0234",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YAZDANI",
"first_name": "UROOJ",
"credential": "MD, M.ED.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-03",
"last_updated": "2023-04-21",
"certification_date": "2023-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "IL",
"license": "Y78954689087",
"primary": true
}
],
"identifiers": [],
"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 Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.