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Individual

YOLANTA KREKLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
Mailing address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209016064
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
209016064
IL
Enumeration date
07/18/2017
Last updated
02/13/2018
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