Young Men'S Christian Association of Berwyn-Cicero

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

YOUNG MEN'S CHRISTIAN ASSOCIATION OF BERWYN-CICERO

Practice address

2947 Oak Park Ave
Berwyn, IL 60402-3048

Phone

(708) 749-0606

Fax

(708) 749-7793

NPI assigned

Oct 21, 2016

Organization subpart

No

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

Authorized official

Name

Jamie Kucera

Title

Executive Director/Ceo

Phone

(708) 749-0606

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Vincent Fortuna, D.C.

  • Chiropractor
  • Berwyn, IL
  • NPI 1538325048
  NPD (past)
• Laura Garcia

  • Health Educator
  • Berwyn, IL
  • NPI 1649773995
  NPD (past)
• Daniel K Treadwell

  • Health Educator
  • Berwyn, IL
  • NPI 1518460914
  NPD (past)

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1750832077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2947 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023048",
            "telephone_number": "708-749-0606",
            "fax_number": "708-749-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2947 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023048",
            "telephone_number": "708-749-0606",
            "fax_number": "708-749-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG MEN'S CHRISTIAN ASSOCIATION OF BERWYN-CICERO",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "KUCERA",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "708-749-0606"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer K Yang, PA-C
• Maria A. Yapondjian, PSY.D.
• Adeel Ahmed Yaseen, MD
• Sirisha D Yellayi, DO
• Darlene Kay Yoder, LCPC
• Krista Dionne Young, DO
• Youth Crossroads, Inc.
• Maria G Yu, PHARMD
• Yeo Yeong Yun, M.D.
• Serena Zacharias, MD

• Health Educator in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Health Educator in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.