Individual
EKALAK YODCHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
850 W IRVING PARK RD, CHICAGO, IL 60613-3077
(773) 525-6780
Mailing address
1598 BAYTREE DR, ROMEOVILLE, IL 60446-4983
(773) 710-5565
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
041.386529
IL
363L00000X
Nurse Practitioner
Primary
209.016427
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209.016427
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017008252
ANCC CERTIFICATION
IL
Enumeration date
09/14/2017
Last updated
02/22/2026
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