Provider Demographics
NPI:1134664279
Name:YOST, MICHELLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:YOST
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24259 S CREE DR
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-3203
Mailing Address - Country:US
Mailing Address - Phone:815-529-3534
Mailing Address - Fax:
Practice Address - Street 1:24259 S CREE DR
Practice Address - Street 2:
Practice Address - City:CHANNAHON
Practice Address - State:IL
Practice Address - Zip Code:60410-3203
Practice Address - Country:US
Practice Address - Phone:815-529-3534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015255363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner