| Yury M Shklyar Md Pc | |
|
1870 W Winchester Rd Suite 144 Libertyville IL 60048-5358 | |
| (847) 680-1200 | |
| (847) 680-1211 |
| Full Name | Yury M Shklyar Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1870 W Winchester Rd, Libertyville, Illinois |
| Authorized Official Name and Position | Yury M Shklyar (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8475485063 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yury M Shklyar Md Pc 1870 W Winchester Rd Suite 144 Libertyville IL 60048-5358 Ph: (847) 680-1200 | Yury M Shklyar Md Pc 1870 W Winchester Rd Suite 144 Libertyville IL 60048-5358 Ph: (847) 680-1200 |
| NPI Number | 1407922677 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 01/20/2010 |
| Medicare PECOS PAC ID | 5294795977 |
|---|---|
| Medicare Enrollment ID | O20041018000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407922677 | NPI | - | NPPES |
| 036090663 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036090663 (Illinois) | Primary |
| Provider Name | Yury Shklyar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558440404 PECOS PAC ID: 5193785871 Enrollment ID: I20101006000286 |
| Provider Name | Zivile Calderon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083005268 PECOS PAC ID: 1153648134 Enrollment ID: I20150401001053 |
| Provider Name | Kristen T Kuhlman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821531880 PECOS PAC ID: 4082994355 Enrollment ID: I20161201001819 |
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