Provider Demographics
NPI:1063835932
Name:YAVUZ, HATICE (PT)
Entity Type:Individual
Prefix:
First Name:HATICE
Middle Name:
Last Name:YAVUZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 W ROSLYN PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2713
Mailing Address - Country:US
Mailing Address - Phone:312-806-1587
Mailing Address - Fax:312-277-7172
Practice Address - Street 1:16 N PEORIA ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607
Practice Address - Country:US
Practice Address - Phone:773-541-2020
Practice Address - Fax:312-277-7172
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070020481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070020481OtherSTATE OF ILLINOIS