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General NPI Number Information
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NPI Number | 1902557382
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Entity Type | Individual
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Provider Name | YOLANDA E MERAZ NP
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Gender | Female
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 2355 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60608-3837
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Country | US
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Telephone | 773-254-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 186 WEDGEPORT CIR
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City | ROMEOVILLE
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State | IL
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Zip | 60446-3758
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041442268
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.024910
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License Number State | IL
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