Individual provider Active NPI

Yvette M. Johnson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Harvey, IL
National Provider Identifier
1043608631
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.014010 Issued in IL
Practice address
31 W. 155TH Street
Harvey, IL 60426
Phone
(708) 596-5177
Fax
(708) 339-3583
NPI assigned
Jan 5, 2015
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.014010 IL Primary

Addresses

Primary practice location

31 W. 155TH Street
Harvey, IL 60426

Mailing address

31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 596-5177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803003164 IL Practitioner - Nurse Practitioner 9931493608 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yvette M Johnson LLCGroup PAC ID 0547525297, 3 clinicians
Theodore Handrup MD LTDGroup PAC ID 5294709887, 7 clinicians

Practice addresses (Care Compare)

1 Ingalls Dr
Harvey, IL 60426-3558
Phone (708) 571-6133

1944 W 163Rd St
Markham, IL 60428-5647
Phone (708) 571-6133

3000 N Halsted St
Suite 802
Chicago, IL 60657-6185
Phone (773) 472-1483

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.014010ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theodore Handrup MD LTD CurrentSince Jan 1, 2025 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Aug 24, 2025 Accepting new patients
Cook County CurrentSince Aug 24, 2025 Accepting new patients
Yvette M Johnson LLC Psychiatric/Mental Health CurrentSince Mar 17, 2018 Accepting new patients
Ingalls Memorial Hospital Past Accepting new patients
Integrated Behavioral Medicine, LTD. Past Accepting new patients

Locations

1900 W Polk St
Ste 220C
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

2800 N Sheridan Rd
Ste 502
Chicago, IL 60657
Phone (773) 472-1483

3000 N Halsted St
Ste 802
Chicago, IL 60657

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

31 W 155th St
Harvey, IL 60426
Phone (708) 596-5177

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1043608631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-339-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W. 155TH STREET",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "60426",
            "telephone_number": "708-596-5177",
            "fax_number": "708-339-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "YVETTE",
        "middle_name": "M.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.014010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.