Brandie Raquel Yancy, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085005981 Issued in IL

Practice address

839 W 79TH St
Chicago, IL 60620-2699

Phone

(312) 492-1220

Fax

(312) 492-1222

NPI assigned

Aug 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: byancy169713@uihealth.direct-ci.com

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.

• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1669493466
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Rockford, IL
  • NPI 1306486022
  NPD
• Board of Trustees of the University of Illinois

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD (past)
• Community Health Providers PLLC

  • Family Medicine Physician
  • Homewood, IL
  • NPI 1184546467
  NPD (past)

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1356717102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15112 EVERS ST",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192621",
            "telephone_number": "708-639-8770",
            "fax_number": "312-492-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 W 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606202699",
            "telephone_number": "312-492-1220",
            "fax_number": "312-492-1222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Otto Blvd",
            "address_purpose": "LOCATION",
            "city": "Chicago Heights",
            "state": "IL",
            "postal_code": "604113871",
            "country_code": "US",
            "telephone_number": "708-733-7200",
            "fax_number": "708-733-7222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15112 Evers St",
            "address_purpose": "LOCATION",
            "city": "Dolton",
            "state": "IL",
            "postal_code": "604192621",
            "country_code": "US",
            "telephone_number": "708-639-8770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 W Paterson St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490072557",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANCY",
        "first_name": "BRANDIE",
        "middle_name": "RAQUEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005981",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yufan Yan
• Yana Kiesau M.D., LLC
• Ruth M. Yanagi, M.D.
• Vivek Yanamadala
• Janeta Yancheva, DO
• Clyde Warren Yancy Jr., M.D.
• Melissa Yanes
• Yanez Psychotherapy PLLC
• Jordee Yanez
• Martha Yanez, M.D.

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.