Provider Demographics
NPI:1275885089
Name:BOOKER, YOLANDA KEVA
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:KEVA
Last Name:BOOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 CLARENCE AVE
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-5113
Mailing Address - Country:US
Mailing Address - Phone:708-674-1766
Mailing Address - Fax:
Practice Address - Street 1:4101 CLARENCE AVE
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-5113
Practice Address - Country:US
Practice Address - Phone:708-674-1766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health