Organization
IL SPROUT MC 1 LLC
Active
Other names
Elemy, Tilly, Sprout Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
YURY YAKUBCHYK SR. (OWNER)
(312) 820-9715
Entity
Organization
Contact information
Practice address
125 S WACKER DR STE 300, CHICAGO, IL 60606-4421
(833) 458-0386
(855) 461-3542
Mailing address
19 W 24TH ST FL 4, NEW YORK, NY 10010-3239
(833) 458-0386
(855) 461-3542
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
07/28/2025
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