Individual provider Active NPI

Yuriy O Moklyak, M.D.

  • Surgery Physician
  • McHenry, IL
National Provider Identifier
1588084339
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036.151520 Issued in IL
Practice address
4309 W Medical Center Dr Ste B202
McHenry, IL 60050-8417
Phone
(815) 455-2752
Fax
(815) 455-2789
NPI assigned
Apr 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036.151520 IL Primary

Addresses

Primary practice location

4309 W Medical Center Dr Ste B202
McHenry, IL 60050-8417

Mailing address

4309 W Medical Center Dr Ste B202
McHenry, IL 60050-8417
Phone (815) 455-2752

Other practice location 1

260 E Congress Pkwy Ste D
Crystal Lake, IL 60014-6235
Phone (815) 455-2752

Other practice location 2

10370 Haligus Rd Ste 201
Huntley, IL 60142-9582
Phone (815) 455-2752

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
I20210121002763 IL Practitioner - General Surgery 4880999598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Northwestern University Feinberg Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 356-2323

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

260 E Congress Pkwy
Crystal Lake, IL 60014-6235
Phone (815) 477-0300

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4874

4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070

4309 W Medical Ctr Dr
Suite A201
McHenry, IL 60050-8411
Phone (815) 759-8070

Hospital & facility affiliations

  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)36
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue60
Removal of skin lesions24
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.151520ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2021 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 15, 2021 Accepting new patients
Central Dupage Physician Group Neurological Surgery CurrentSince Sep 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

251 E Huron St
Chicago, IL 60611

259 E Erie St
Ste 1600
Chicago, IL 60611

360 Station Dr
Ste 300
Crystal Lake, IL 60014
Phone (815) 455-1800

260 E Congress Pkwy
Ste D
Crystal Lake, IL 60014
Phone (815) 759-6363

10370 Haligus Rd
Ste 201
Huntley, IL 60142
Phone (815) 356-5200

4309 W Medical Center Dr
Ste B202
McHenry, IL 60050
Phone (815) 344-3900

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

5668 E State St
Rockford, IL 61108
Phone (815) 229-7580

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 5

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 3

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": "1397952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1588084339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE B202",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508417",
            "telephone_number": "815-455-2752",
            "fax_number": "815-455-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE B202",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508417",
            "telephone_number": "815-455-2752",
            "fax_number": "815-455-2789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 E Congress Pkwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600146235",
            "country_code": "US",
            "telephone_number": "815-455-2752",
            "fax_number": "815-455-2789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10370 Haligus Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429582",
            "country_code": "US",
            "telephone_number": "815-455-2752",
            "fax_number": "815-455-2789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOKLYAK",
        "first_name": "YURIY",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-20",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.151520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.