Provider Demographics
NPI:1316498934
Name:YOINGCO, MELANIE DACUMOS (BSN, AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:DACUMOS
Last Name:YOINGCO
Suffix:
Gender:
Credentials:BSN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2499 DOWNING CT
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1095
Mailing Address - Country:US
Mailing Address - Phone:224-399-9500
Mailing Address - Fax:
Practice Address - Street 1:11201 BENTON ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92357-2433
Practice Address - Country:US
Practice Address - Phone:909-825-2089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041285592163WC0200X
IL209.015147363LC0200X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1316498934Medicaid
IL1316498934Medicaid