Mayra Yadira Isidoro

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

58 E Clinton St
Joliet, IL 60432-4143

Phone

(815) 723-0331

NPI assigned

Apr 22, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1669092359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 S VILLA AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263030",
            "telephone_number": "630-843-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 E CLINTON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604324143",
            "telephone_number": "815-723-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISIDORO",
        "first_name": "MAYRA",
        "middle_name": "YADIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• International Dental Center
• International Dental Center
• International Dental Joliet
• Angela Intili, M.D.
• Ipm Service Company LLC (Integrated Physical Medicine)
• Sakeba N Issa, M.D.
• Issan Health Care Group LTD
• Tracey Ivan
• Iyad Awadallah DMD PC
• J D Brown & Co Inc (J D Brown Pharmacy)

• Social Worker in Joliet, IL
• Providers in Joliet, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.