Individual provider Active NPI

Yvonne Renee McLeod, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1821007212
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-025074 Issued in IL
Practice address
9119 S Exchange Ave
Chicago Family Health Center
Chicago, IL 60617-4225
Phone
(773) 768-5001
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12010824A IN
Dentist 122300000X 019-025074 IL Primary

Addresses

Primary practice location

9119 S Exchange Ave
Chicago Family Health Center
Chicago, IL 60617-4225

Mailing address

6746 S Cregier Ave
Chicago, IL 60649-1020
Phone (773) 322-4530

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address yvonne.mcleod@direct.ccprovider.org Direct Cook County

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190422001786 IL Practitioner - Dentist 4880936954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-025074ILMDDentist
12010824AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County CurrentSince Mar 22, 2019 Accepting new patients
Cook County CurrentSince Mar 22, 2019 Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

Interoperability endpoints

  • Direct secure messaging: yvonne.mcleod@direct.ccprovider.org

Organizations & group practices 3

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1821007212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6746 S CREGIER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606491020",
            "telephone_number": "773-322-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "address_2": "CHICAGO FAMILY HEALTH CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "YVONNE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010824A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-025074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yvonne.mcleod@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.