MEDICARE: MRS. YVETTE J YONAN 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	104100000X	Social Worker	149.013995	IL
2	171M00000X	Case Manager/Care Coordinator	149.013995	IL
3	1041C0700X	Clinical Social Worker	149.013995	IL

General Provider Information

NPI Number	:	1740510742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YVETTE J YONAN LCSW

Provider Business Mailing Address
First Line	:	875 N MICHIGAN AVE STE 3100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-1962
Country	:	US
Telephone Number	:	312-544-0551
Fax Number	:

Provider Business Practice Location Address
First Line	:	875 N MICHIGAN AVE STE 3100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-1962
Country	:	US
Telephone Number	:	312-544-0551
Fax Number	:

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

Provider Enumeration Date	:	01/13/2010
Last Update Date	:	08/26/2020

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