Healthcare Provider Details

I. General information

NPI: 1215861356
Provider Name (Legal Business Name): YOLANDA HUERTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YOLANDA HUERTA-RAMIREZ

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JORIE BLVD STE 228
OAK BROOK IL
60523-4481
US

IV. Provider business mailing address

1000 JORIE BLVD STE 228
OAK BROOK IL
60523-4481
US

V. Phone/Fax

Practice location:
  • Phone: 331-218-2777
  • Fax: 630-861-6188
Mailing address:
  • Phone: 331-218-2777
  • Fax: 630-861-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.001966
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: