Individual provider Active NPI

Tania M Yackle, LCSW

  • Clinical Social Worker
  • Downers Grove, IL
National Provider Identifier
1104209832
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.009344 Issued in IL
Practice address
900 Ogden Ave Ste 144
Downers Grove, IL 60515-2829
Phone
(630) 474-1257
NPI assigned
Jun 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.009344 IL Primary

Addresses

Primary practice location

900 Ogden Ave Ste 144
Downers Grove, IL 60515-2829

Mailing address

4520 Drendel Rd
Downers Grove, IL 60515-2421
Phone (312) 301-3820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.009344ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie View Counseling, PLLC Clinical CurrentSince Feb 9, 2025 Accepting new patients

Locations

900 Ogden Ave
Downers Grove, IL 60515
Phone (773) 234-0388

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1104209832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 DRENDEL RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152421",
            "telephone_number": "312-301-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 OGDEN AVE STE 144",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152829",
            "telephone_number": "630-474-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACKLE",
        "first_name": "TANIA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.009344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.