MEDICARE: MRS. ANNA E YAS LCSW

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	1041C0700X	Clinical Social Worker	149.018904	IL

General Provider Information

NPI Number	:	1457013203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA E YAS LCSW

Provider Business Mailing Address
First Line	:	3045 W SUNNYSIDE AVE # 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3846
Country	:	US
Telephone Number	:	612-242-6064
Fax Number	:

Provider Business Practice Location Address
First Line	:	3166 N LINCOLN AVE STE 400B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3174
Country	:	US
Telephone Number	:	612-242-6064
Fax Number	:

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

Provider Enumeration Date	:	10/08/2021
Last Update Date	:	10/08/2021

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