Healthcare Provider Details

I. General information

NPI: 1104457555
Provider Name (Legal Business Name): YASHIKA DOMINIQUE COOK-HILL I NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 02/15/2026
Certification Date: 02/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W 69TH ST
CHICAGO IL
60621-3767
US

IV. Provider business mailing address

2613 KNOLLWOOD PL
HAZEL CREST IL
60429-2138
US

V. Phone/Fax

Practice location:
  • Phone: 773-820-3918
  • Fax:
Mailing address:
  • Phone: 773-820-3918
  • Fax: 844-230-8588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.020871
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.361314
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: