Doctor Name: | SUSAN YACOBELLIS |
NPI Number: | 1043232184 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 149000098 |
Business Practice Address: | 2024 Hickory Rd Suite 104 Homewood, IL - 604302125 |
Business Phone Number: | 7087986823 |
Business Fax Number: | |
Mailing Address: | 2024 Hickory Rd, Suite 104 HOMEWOOD |
State: | IL |
Postal Code: | 604302125 |
Phone Number: | 7087986823 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2006 |
NPI Last Update Date: | 08/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149000098 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |