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General NPI Number Information
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NPI Number | 1164495099
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Entity Type | Individual
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Provider Name | CHRISTOPHER M YADRON MA LCPC CADC
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Gender | Male
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 15030 S RAVINIA AVE STE 30
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City | ORLAND PARK
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State | IL
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Zip | 60462-3258
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Country | US
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Telephone | 630-863-0104
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Fax |
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Provider Business Mailing Address
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Address Line | 11253 S DEPOT ST
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City | WORTH
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State | IL
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Zip | 60482-1812
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Country | US
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Telephone | 630-863-0104
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180006390
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License Number State | IL
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