Yvonne Lynn Fornoff, BSN, RN, CCM

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

041.299119 Issued in IL

Practice address

7619 NCR 32
Havana, IL 62644-6264

Phone

(309) 215-8213

Fax

(866) 260-8572

NPI assigned

Oct 6, 2022

Last updated

Oct 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1619692118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 NCR 32",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626446264",
            "telephone_number": "309-215-8213",
            "fax_number": "866-260-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7619 NCR 32",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626446264",
            "telephone_number": "309-215-8213",
            "fax_number": "866-260-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNOFF",
        "first_name": "YVONNE",
        "middle_name": "LYNN",
        "credential": "BSN, RN, CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "IL",
            "license": "041.299119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yvonne.fornoff@genexservices.com",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7619 NCR 32",
            "city": "Havana",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Case Management Registered Nurse in Havana, IL
• Providers in Havana, IL by specialty
• Case Management Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.