Individual provider Active NPI

Bryan Yonka, A.T.C.

  • Athletic Trainer
  • Chicago, IL
National Provider Identifier
1386920544
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096001181 Issued in IL
Practice address
1032 W Sheridan Rd
Chicago, IL 60660-1537
Phone
(773) 508-2709
Fax
(773) 508-3884
NPI assigned
Nov 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096001181 IL Primary

Addresses

Primary practice location

1032 W Sheridan Rd
Chicago, IL 60660-1537

Mailing address

5713 N Melvina Ave
Chicago, IL 60646-6121
Phone (773) 495-1052

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
096001181ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1386920544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5713 N MELVINA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466121",
            "telephone_number": "773-495-1052",
            "fax_number": "773-508-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 W SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601537",
            "telephone_number": "773-508-2709",
            "fax_number": "773-508-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONKA",
        "first_name": "BRYAN",
        "credential": "A.T.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096001181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.