Yevgenia Gavrielov

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

2474029 Issued in IL

Practice address

631 Concord Way
Prospect Heights, IL 60070-3429

Phone

(224) 639-5558

NPI assigned

Aug 25, 2014

Last updated

Aug 25, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1760882088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 CONCORD WAY",
            "city": "PROSPECT HEIGHTS",
            "state": "IL",
            "postal_code": "600703429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 CONCORD WAY",
            "city": "PROSPECT HEIGHTS",
            "state": "IL",
            "postal_code": "600703429",
            "telephone_number": "224-639-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRIELOV",
        "first_name": "YEVGENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "IL",
            "license": "2474029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katarzyna Zofia Dymon, PHARMD
• Eduardo Villa, M.D., S.C.
• Letitia Fabian, APN-CNP
• Alexander Fedorov, D.C.
• Madalyn Sharon Flynn
• Adina Gong
• April Goocher, PHARMD
• Polina Goridko-Esquivel
• Kristen E Hackel, DPT
• Pamela Joyce Haerr

• Case Manager/Care Coordinator in Prospect Heights, IL
• Providers in Prospect Heights, IL by specialty
• Case Manager/Care Coordinator in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.