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NPI Code Detail

MEDICARE: YEILLIE CONCEPCION APN

MEDICARE: YEILLIE CONCEPCION APN
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
1363L00000XNurse Practitioner041189894IL

General Provider Information

NPI Number : 1740372622
Entity Type Code : Individual
Provider Name (Legal Business Name) : YEILLIE CONCEPCION APN
Provider Business Mailing Address
First Line : 809 S MARSHFIELD AVE
Second Line : 9TH FLOOR (M/C 732)
City : CHICAGO
State : IL
Zip : 60612-4305
Country : US
Telephone Number : 312-996-7699
Fax Number : 312-996-1001
Provider Business Practice Location Address
First Line : 1740 W TAYLOR ST
Second Line : SUITE 3300
City : CHICAGO
State : IL
Zip : 60612-7232
Country : US
Telephone Number : 312-996-7487
Fax Number : 312-996-0221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 02/20/2009

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