MEDICARE: MS. YOONA HANNIGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	178012516	IL

General Provider Information

NPI Number	:	1972012029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YOONA HANNIGAN

Provider Business Mailing Address
First Line	:	3100 W CULLOM AVE # 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-1304
Country	:	US
Telephone Number	:	773-706-9588
Fax Number	:

Provider Business Practice Location Address
First Line	:	6737 W FOREST PRESERVE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-1470
Country	:	US
Telephone Number	:	773-286-6226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2017
Last Update Date	:	09/21/2017

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