Provider Demographics
NPI:1992132849
Name:YAKOS THERAPY PC
Entity type:Organization
Organization Name:YAKOS THERAPY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKOS
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, CCC-SLP/L
Authorized Official - Phone:815-304-5548
Mailing Address - Street 1:200 E COURT ST STE 708
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3845
Mailing Address - Country:US
Mailing Address - Phone:815-304-5548
Mailing Address - Fax:815-304-5548
Practice Address - Street 1:200 E COURT ST STE 708
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3845
Practice Address - Country:US
Practice Address - Phone:815-304-5548
Practice Address - Fax:815-304-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-07
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD1600X
IL146011221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1194260794OtherPRIVATE HEALTH INSURANCE
IL1093288904OtherPRIVATE HEALTH INSURANCE
IL1871874826OtherPRIVATE HEALTH INSURANCE
IL1700346327OtherPRIVATE HEALTH INSURANCE
IL1972069730OtherPRIVATE HEALTH INSURANCE
IL1588837710OtherPRIVATE HEALTH INSURANCE