Provider Demographics
NPI:1669574398
Name:THE YELLIN HOLISTIC CENTER FOR BEING WELL INC.
Entity type:Organization
Organization Name:THE YELLIN HOLISTIC CENTER FOR BEING WELL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:YELLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-482-1488
Mailing Address - Street 1:1025 W EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2697
Mailing Address - Country:US
Mailing Address - Phone:847-482-1488
Mailing Address - Fax:847-482-1489
Practice Address - Street 1:1025 W EVERETT RD
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2697
Practice Address - Country:US
Practice Address - Phone:847-482-1488
Practice Address - Fax:847-482-1489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04915382OtherBLUE CROSS/BLUE SHIELD
ILU42530Medicare UPIN
IL04915382OtherBLUE CROSS/BLUE SHIELD