Healthcare Provider Details

I. General information

NPI: 1053227538
Provider Name (Legal Business Name): YONI ZEV RUBIN I
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 W PETERSON AVE
CHICAGO IL
60659-3919
US

IV. Provider business mailing address

6727 N TRUMBULL AVE
LINCOLNWOOD IL
60712-3739
US

V. Phone/Fax

Practice location:
  • Phone: 773-937-7527
  • Fax:
Mailing address:
  • Phone: 773-209-0301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: