Provider Demographics
NPI:1215048111
Name:YEUNG, VERONICA (NP)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:YEUNG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:DEL REAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1301 W WASHINGTON BLVD
Mailing Address - Street 2:#403
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607
Mailing Address - Country:US
Mailing Address - Phone:773-469-1846
Mailing Address - Fax:312-666-4163
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:STE 408B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-997-2229
Practice Address - Fax:312-666-4163
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041 315138163W00000X
IL209 005256363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1616020OtherBCBS