Provider Demographics
NPI:1740510742
Name:YONAN, YVETTE J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:J
Last Name:YONAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 N MICHIGAN AVE STE 3100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-1962
Mailing Address - Country:US
Mailing Address - Phone:312-544-0551
Mailing Address - Fax:
Practice Address - Street 1:875 N MICHIGAN AVE STE 3100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1962
Practice Address - Country:US
Practice Address - Phone:312-544-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.013995104100000X, 171M00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL5668Medicare PIN
ILIL7124001Medicare PIN