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General NPI Number Information
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NPI Number | 1962643999
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Entity Type | Organization
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Legal Business Name | JEANNE YAKIN LTD
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Dates
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Enumeration Date | 03/21/2009
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 500 LAKE COOK RD SUITE 350
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City | DEERFIELD
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State | IL
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Zip | 60015-5609
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Country | US
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Telephone | 847-597-7047
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Fax | 847-282-5001
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Provider Business Mailing Address
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Address Line | 500 LAKE COOK RD SUITE 350
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City | DEERFIELD
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State | IL
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Zip | 60015-5609
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Country | US
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Telephone | 847-597-7047
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Fax | 847-282-5001
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEANNE YAKIN
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Credential | PH.D.
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Telephone | 312-342-0266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.007436
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License Number State | IL
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