Provider Demographics
NPI:1366778334
Name:YACKER, TOMI L (BSN, NCTMB, LMT)
Entity type:Individual
Prefix:MS
First Name:TOMI
Middle Name:L
Last Name:YACKER
Suffix:
Gender:F
Credentials:BSN, NCTMB, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38775 N GILBERT AVE
Mailing Address - Street 2:
Mailing Address - City:BEACH PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60099-3859
Mailing Address - Country:US
Mailing Address - Phone:224-374-7808
Mailing Address - Fax:847-623-7837
Practice Address - Street 1:38775 N GILBERT AVE
Practice Address - Street 2:
Practice Address - City:BEACH PARK
Practice Address - State:IL
Practice Address - Zip Code:60099-3859
Practice Address - Country:US
Practice Address - Phone:224-374-7808
Practice Address - Fax:847-623-7837
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.009648172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist