Provider Demographics
NPI:1093462012
Name:YU, KEVIN (MS)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4400
Mailing Address - Country:US
Mailing Address - Phone:312-209-2288
Mailing Address - Fax:
Practice Address - Street 1:1007 ARBOR CT
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-4400
Practice Address - Country:US
Practice Address - Phone:312-209-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001542106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist