Active NPI
Yana Kiesau, MD
- Ophthalmology Physician
- Chicago, IL
National Provider Identifier
1861658635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036121102
- Practice address
- 2300 N Childrens PLZ
Box 70
Chicago, IL 60614-3363 - Phone
- (773) 880-4346
- NPI assigned
- Jul 31, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036121102 | IL | Primary |
Addresses
Primary practice location
2300 N Childrens PLZ
Box 70
Chicago, IL 60614-3363
Mailing address
2300 N Childrens PLZ
Box 70
Chicago, IL 60614-3363
Phone (773) 880-4346
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036121102 | IL | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1861658635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 N CHILDRENS PLZ",
"address_2": "BOX 70",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606143363",
"telephone_number": "773-880-4346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 N CHILDRENS PLZ",
"address_2": "BOX 70",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606143363",
"telephone_number": "773-880-4346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIESAU",
"first_name": "YANA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-31",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036121102",
"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 Dec 22, 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.