MEDICARE: ANNA YONKELOWITZ RN, FNP-C

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	209.010793	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12656875	OTHER	IL	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	QXIPQ0000136409	OTHER	IL	AETNA BETTER HEALTH

General Provider Information

NPI Number	:	1700207784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA YONKELOWITZ RN, FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 3603
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60522-3603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2331 W CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-4723
Country	:	US
Telephone Number	:	773-772-7858
Fax Number	:

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

Provider Enumeration Date	:	12/18/2013
Last Update Date	:	03/07/2023

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