Provider Demographics
NPI:1316238595
Name:YIANAS, GEORGIA (AUD)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:
Last Name:YIANAS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:GEORGIA
Other - Middle Name:
Other - Last Name:HAAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:11 SALT CREEK LN STE 101
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3032
Mailing Address - Country:US
Mailing Address - Phone:630-789-3110
Mailing Address - Fax:
Practice Address - Street 1:11 SALT CREEK LN STE 101
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3032
Practice Address - Country:US
Practice Address - Phone:630-789-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000775231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist