MEDICARE: MS. AVEVA TAMARA YUFIT MA, LCPC

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	101YP2500X	Professional Counselor		IL

General Provider Information

NPI Number	:	1154330314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AVEVA TAMARA YUFIT MA, LCPC

Provider Business Mailing Address
First Line	:	5308 S HYDE PARK BLVD
Second Line	:	APT. 1F
City	:	CHICAGO
State	:	IL
Zip	:	60615-5737
Country	:	US
Telephone Number	:	773-363-4012
Fax Number	:	773-363-2868

Provider Business Practice Location Address
First Line	:	30 N MICHIGAN AVE
Second Line	:	SUITE 1819
City	:	CHICAGO
State	:	IL
Zip	:	60602-3402
Country	:	US
Telephone Number	:	773-363-2868
Fax Number	:	773-363-2868

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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