Provider Demographics
NPI:1740357359
Name:WARNER-LEWIS, YOLANDA M (OT)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:M
Last Name:WARNER-LEWIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:
Practice Address - Street 1:17045 TORRENCE AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-1014
Practice Address - Country:US
Practice Address - Phone:708-418-3580
Practice Address - Fax:708-418-3931
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056000890225X00000X
IN31001865A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL600040OtherMEDICARE GROUP NUMBER
IL1619908OtherBCBS IL GROUP
IL211781OtherMARTIN R HALL MD SC MEDICARE GROUP NUMBER
IL600040OtherMEDICARE GROUP NUMBER
ILK50669Medicare PIN