Provider Demographics
NPI:1841242328
Name:SCHOONOVER, YVONNE (APN)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 ROXBURY RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5089
Mailing Address - Country:US
Mailing Address - Phone:815-227-8300
Mailing Address - Fax:815-227-8301
Practice Address - Street 1:612 ROXBURY RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5089
Practice Address - Country:US
Practice Address - Phone:815-227-8300
Practice Address - Fax:815-227-8301
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209005408363LA2200X
IL041268938163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1616108OtherBCBS
IL$$$$$$$$$001Medicaid
Q38360Medicare UPIN
IL$$$$$$$$$001Medicaid
IL211215Medicare PIN
IL1616108OtherBCBS