Individual provider Active NPI

Dana Beth Yednock, DNP, WHNP-BC, APRN

  • Women's Health Nurse Practitioner
  • Streator, IL
National Provider Identifier
1881292019
Registry record updated Oct 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
209022080 Issued in IL
Practice address
1444 E Broadway St
Streator, IL 61364-2535
Phone
(815) 822-5647
NPI assigned
Oct 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209022080 IL Primary

Addresses

Primary practice location

1444 E Broadway St
Streator, IL 61364-2535

Mailing address

1444 E Broadway St
Streator, IL 61364-2535
Phone (815) 822-5647

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220601000266 IL Practitioner - Nurse Practitioner 0941688196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

111 Spring St
Streator, IL 61364-3332
Phone (815) 673-2311

1614 E Norris Dr
OBGYN and Anti Coag
Ottawa, IL 61350-3681
Phone (815) 431-0435

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209022080ILMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince May 20, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

1614 E Norris Dr
Ottawa, IL 61350
Phone (815) 433-1010

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1602288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602288000000",
    "number": "1881292019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 E BROADWAY ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642535",
            "telephone_number": "815-822-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 E BROADWAY ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642535",
            "telephone_number": "815-822-5647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEDNOCK",
        "first_name": "DANA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "DNP, WHNP-BC, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-10",
        "last_updated": "2020-10-10",
        "certification_date": "2020-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209022080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streator, IL

Sources for this page

Verify at the official NPI Registry.