Individual
MS. TARA DENISE YATES II
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
E 65TH ST AT LAKE MICHIGAN, CHICAGO, IL 60649-1395
(773) 256-5799
Mailing address
9141 S UTICA AVE, EVERGREEN PARK, IL 60805-1722
(708) 423-2793
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
IL
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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