Provider Demographics
NPI:1427523091
Name:YAMBOR, ALLISON POPPER (LCSW MA)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:POPPER
Last Name:YAMBOR
Suffix:
Gender:F
Credentials:LCSW MA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:POPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:346 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-3047
Mailing Address - Country:US
Mailing Address - Phone:847-924-7743
Mailing Address - Fax:
Practice Address - Street 1:770 LAKE COOK RD STE 220
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4920
Practice Address - Country:US
Practice Address - Phone:847-924-7743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
149.0107391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical