Individual
YVETTE T OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 E IRVING PARK RD, STREAMWOOD, IL 60107-3201
(630) 837-9000
(630) 540-3927
Mailing address
590 AUDUBON ST, HOFFMAN ESTATES, IL 60169-1974
(224) 213-5265
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.004959
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
35158
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13823078
CAQH
IL
Enumeration date
11/14/2019
Last updated
11/14/2019
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