Individual provider Active NPI

Jennifer Lynn Yonaka, MSW, LCSW

  • Clinical Social Worker
  • Scott AFB, IL
National Provider Identifier
1639317720
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-007757 Issued in IL
Practice address
310 W Losey St
Scott AFB, IL 62225-5250
Phone
(618) 256-9355
NPI assigned
Jan 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-007757 IL Primary
Social Worker 104100000X

Addresses

Primary practice location

310 W Losey St
Scott AFB, IL 62225-5250

Mailing address

310 W Losey St
Scott AFB, IL 62225-5250
Phone (618) 256-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709000986 IL Practitioner - Clinical Social Worker 4284179862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Southern Illinois University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

3354 Jerome LN
Cahokia, IL 62206-2604
Phone (618) 337-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-007757ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince Jun 1, 2024 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400

3450 Oakton St
Ste 300
Skokie, IL 60076

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": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1639317720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W LOSEY ST",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "622255250",
            "telephone_number": "618-256-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W LOSEY ST",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "622255250",
            "telephone_number": "618-256-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONAKA",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-007757",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott AFB, IL

Sources for this page

Verify at the official NPI Registry.