Healthcare Provider Details

I. General information

NPI: 1427770890
Provider Name (Legal Business Name): YELIDA CLARK ALMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 S QUENTIN RD STE 103
PALATINE IL
60067-6778
US

IV. Provider business mailing address

1425 E EVERGREEN DR APT 102
PALATINE IL
60074-8723
US

V. Phone/Fax

Practice location:
  • Phone: 847-359-7490
  • Fax:
Mailing address:
  • Phone: 646-706-3227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number208.011475
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: