Individual
YAFFA Y KAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(475) 702-3048
(847) 733-5247
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(475) 702-3048
(847) 733-5247
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
630717
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
309.013317
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
401647
NY
Other
Enumeration date
07/13/2013
Last updated
04/27/2022
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