Provider Information for 1245792613
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BRIANNA L. YATES LCSW
Sex: Female
NPI: 1245792613
Last Updated: 2022-05-12
Certification Date: 2022-05-12
Certification Date: 2022-05-12
Details
| Name | Value | |||||||||||||||||||||
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| NPI | 1245792613 | |||||||||||||||||||||
| Enumeration Date | 2019-04-03 | |||||||||||||||||||||
| NPI Type | NPI-1 Individual | |||||||||||||||||||||
| Sole Proprietor | YES | |||||||||||||||||||||
| Status | Active | |||||||||||||||||||||
| Mailing Address | 29373 NETWORK PL CHICAGO, IL 60673-1293 United States Phone: 847-390-5900 | Fax: | |||||||||||||||||||||
| Primary Practice Address | 4400 W 95TH ST STE 404 OAK LAWN, IL 60453-7216 United States Phone: 708-684-3980 | Fax:708-520-1986 | |||||||||||||||||||||
| Secondary Practice Address(es) | 1901 N ROSELLE RD STE 823 | |||||||||||||||||||||
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