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General NPI Number Information
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NPI Number | 1497293229
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Entity Type | Individual
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Provider Name | YOLANDA ZOLETA
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Gender | Female
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 6323 N AVONDALE AVE STE 102
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City | CHICAGO
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State | IL
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Zip | 60631-1958
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Country | US
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Telephone | 773-594-1923
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Fax | 773-594-1924
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Provider Business Mailing Address
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Address Line | 3507 LAKEWOOD DR
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City | CRYSTAL LAKE
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State | IL
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Zip | 60012-2078
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Country | US
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Telephone | 773-594-1923
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Fax | 773-594-1924
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | IL
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