Organization Active NPI

Yana Kiesau M.D., LLC

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1528430873
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036.121102 Issued in IL
Legal business name
YANA KIESAU M.D., LLC
Practice address
3423 N Seeley Ave
Chicago, IL 60618-6113
Phone
(312) 203-1727
NPI assigned
Oct 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Yana Kiesau, M.D.
Title
Director
Phone
(312) 203-1727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 036.121102 IL Primary

Addresses

Primary practice location

3423 N Seeley Ave
Chicago, IL 60618-6113

Mailing address

3423 N Seeley Ave
Chicago, IL 60618-6113
Phone (312) 203-1727

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1528430873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 N SEELEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186113",
            "telephone_number": "312-203-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3423 N SEELEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186113",
            "telephone_number": "312-203-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YANA KIESAU M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "KIESAU",
        "authorized_official_first_name": "YANA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "312-203-1727",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036.121102",
            "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 Oct 27, 2015; 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.