Provider Demographics
NPI:1194428540
Name:SANDERS, YOLANDA (EDD)
Entity type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1863 W 107TH ST APT F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-3365
Mailing Address - Country:US
Mailing Address - Phone:773-330-3619
Mailing Address - Fax:
Practice Address - Street 1:246 E JANATA BLVD STE 245
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5382
Practice Address - Country:US
Practice Address - Phone:630-785-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.018999101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional