1609974823 NPI number — MRS. BARBARA G YALE AUDIOLOGIST

Table of content: MRS. BARBARA G YALE AUDIOLOGIST (NPI 1609974823)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609974823 NPI number — MRS. BARBARA G YALE AUDIOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YALE
Provider First Name:
BARBARA
Provider Middle Name:
G
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AUDIOLOGIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609974823
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3601 N BELT W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVILLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62226-5937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-235-8083
Provider Business Mailing Address Fax Number:
618-641-4777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3601 N BELT W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62226-5937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-235-8083
Provider Business Practice Location Address Fax Number:
618-641-4777
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  147000430 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 371156494 . This is a "HEALTHNET" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 371156494 . This is a "FEIN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 08232060 . This is a "BLUE CROSS/ILLINOIS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 126800 . This is a "BLUE CHOICE/MISSOURI" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 259553 . This is a "HEALTHLINK" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 371156494 . This is a "MERCY HEALTH PLANS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 4500110 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 640001199 . This is a "RAILROAD RETIREMENT" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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