Provider Demographics
NPI:1821007212
Name:MCLEOD, YVONNE RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:RENEE
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6746 S CREGIER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1020
Mailing Address - Country:US
Mailing Address - Phone:773-322-4530
Mailing Address - Fax:
Practice Address - Street 1:9119 S EXCHANGE AVE
Practice Address - Street 2:CHICAGO FAMILY HEALTH CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-4225
Practice Address - Country:US
Practice Address - Phone:773-768-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010824A122300000X
IL019-025074122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist