Provider Demographics
NPI:1285362350
Name:TORO, YADIRA
Entity type:Individual
Prefix:
First Name:YADIRA
Middle Name:
Last Name:TORO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 W 111TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2715
Mailing Address - Country:US
Mailing Address - Phone:312-278-7129
Mailing Address - Fax:773-233-6111
Practice Address - Street 1:3301 W 111TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2715
Practice Address - Country:US
Practice Address - Phone:312-278-7129
Practice Address - Fax:773-233-6111
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150106971104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker