Provider Demographics
NPI:1528951688
Name:YOON, HAEYOON (OTRL)
Entity type:Individual
Prefix:
First Name:HAEYOON
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4527 NICKLAUS DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-1166
Mailing Address - Country:US
Mailing Address - Phone:989-928-1426
Mailing Address - Fax:989-928-1426
Practice Address - Street 1:4527 NICKLAUS DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-1166
Practice Address - Country:US
Practice Address - Phone:989-928-1426
Practice Address - Fax:989-928-1426
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056010541225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist