Healthcare Provider Details

I. General information

NPI: 1841103801
Provider Name (Legal Business Name): YULISSA D ALVAREZ-DURAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2641 CLOUGH AVE
HIGHLAND IN
46322-1904
US

IV. Provider business mailing address

2641 CLOUGH AVE
HIGHLAND IN
46322-1904
US

V. Phone/Fax

Practice location:
  • Phone: 219-413-6261
  • Fax:
Mailing address:
  • Phone: 219-413-6261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.131095
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: