Healthcare Provider Details

I. General information

NPI: 1508126897
Provider Name (Legal Business Name): YOOMI KENYON BRENDEL APN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 DELNOR DR
GENEVA IL
60134-4222
US

IV. Provider business mailing address

351 DELNOR DR
GENEVA IL
60134-4222
US

V. Phone/Fax

Practice location:
  • Phone: 630-232-0280
  • Fax: 630-232-3895
Mailing address:
  • Phone: 630-232-0280
  • Fax: 630-232-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209009499
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209009499
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: