Healthcare Provider Details

I. General information

NPI: 1215048111
Provider Name (Legal Business Name): VERONICA YEUNG N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VERONICA DEL REAL N.P.

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST STE 408B
CHICAGO IL
60612-3841
US

IV. Provider business mailing address

1301 W WASHINGTON BLVD #403
CHICAGO IL
60607
US

V. Phone/Fax

Practice location:
  • Phone: 312-997-2229
  • Fax: 312-666-4163
Mailing address:
  • Phone: 773-469-1846
  • Fax: 312-666-4163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041 315138
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209 005256
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: