Individual provider Active NPI

Yuri Fernandez

  • Social Worker
  • Libertyville, IL
National Provider Identifier
1316719271
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.112010 Issued in IL
Practice address
1860 W Winchester Rd Ste 205
Libertyville, IL 60048-5317
Phone
(224) 424-4194
NPI assigned
Oct 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.112010 IL Primary

Addresses

Primary practice location

1860 W Winchester Rd Ste 205
Libertyville, IL 60048-5317

Mailing address

647 Countryside Hwy
Mundelein, IL 60060-2501
Phone (224) 864-0955

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
150.112010ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The McKnight Group LLC CurrentSince Oct 29, 2023 Accepting new patients

Locations

1850 W Winchester Rd
Ste 108
Libertyville, IL 60048
Phone (224) 424-4194

1860 W Winchester Rd
Ste 205
Libertyville, IL 60048
Phone (224) 424-4102

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": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1316719271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 COUNTRYSIDE HWY",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600602501",
            "telephone_number": "224-864-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 W WINCHESTER RD STE 205",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485317",
            "telephone_number": "224-424-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "YURI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.112010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.