Provider Demographics
NPI:1215536479
Name:BAUGH, YOLANDA D (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:D
Last Name:BAUGH
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4825
Mailing Address - Country:US
Mailing Address - Phone:224-489-8357
Mailing Address - Fax:
Practice Address - Street 1:2090 LARKIN AVE STE 5A2
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5849
Practice Address - Country:US
Practice Address - Phone:224-454-1719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTEMP249183363LP0808X
IL377.002103363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty