Provider Demographics
NPI:1699877332
Name:YELLIN, LINDA JOYCE (DC)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JOYCE
Last Name:YELLIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2697
Mailing Address - Country:US
Mailing Address - Phone:847-482-1488
Mailing Address - Fax:847-482-1488
Practice Address - Street 1:1025 W EVERETT RD
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2697
Practice Address - Country:US
Practice Address - Phone:847-482-1488
Practice Address - Fax:847-482-1488
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006005111N00000X
CT000942111N00000X
MD1485111N00000X
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04915382OtherBLUE CROSS/BLUE SHIELD
IL214306Medicare PIN
ILU42530Medicare UPIN