MEDICARE: YANA DYMARSKIY APRN, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	201038	OTHER	IL	HCFA

General Provider Information

NPI Number	:	1154322097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANA DYMARSKIY APRN, FNP

Provider Business Mailing Address
First Line	:	6829 N LAKEWOOD AVE
Second Line	:	APT 3
City	:	CHICAGO
State	:	IL
Zip	:	60626-3876
Country	:	US
Telephone Number	:	773-262-1581
Fax Number	:	312-266-8797

Provider Business Practice Location Address
First Line	:	1200 N LASALLE ST
Second Line	:	PLANNED PARENTHOOD
City	:	CHICAGO
State	:	IL
Zip	:	60610-1913
Country	:	US
Telephone Number	:	312-266-1033
Fax Number	:	312-266-8997

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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