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NPI Code Detail

MEDICARE: NELLYA YONOVICH

MEDICARE: NELLYA YONOVICH
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
1101YP2500XProfessional Counselor180010812IL

General Provider Information

NPI Number : 1639670631
Entity Type Code : Individual
Provider Name (Legal Business Name) : NELLYA YONOVICH
Provider Business Mailing Address
First Line : 950 LEE ST
Second Line :
City : DES PLAINES
State : IL
Zip : 60016-6532
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 917 SHERWOOD DR
Second Line :
City : LAKE BLUFF
State : IL
Zip : 60044-2224
Country : US
Telephone Number : 877-486-4140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2018
Last Update Date : 02/24/2018

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