Provider Demographics
NPI:1053188433
Name:AGUILAR, YASMIN (PMHNP)
Entity type:Individual
Prefix:MISS
First Name:YASMIN
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 388556
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-8556
Mailing Address - Country:US
Mailing Address - Phone:708-304-3010
Mailing Address - Fax:708-575-5333
Practice Address - Street 1:6015 W 63RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-4357
Practice Address - Country:US
Practice Address - Phone:708-304-3010
Practice Address - Fax:708-575-5333
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028892363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health