Provider Demographics
NPI:1750454914
Name:RILEY, YVONNE (BS, CADC)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:BS, CADC
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:
Other - Last Name:SHEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 W LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-2237
Mailing Address - Country:US
Mailing Address - Phone:815-895-0552
Mailing Address - Fax:
Practice Address - Street 1:12 HEALTH SERVICES DR
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-9637
Practice Address - Country:US
Practice Address - Phone:815-756-4875
Practice Address - Fax:815-756-2944
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15627101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)