Provider Demographics
NPI:1114801024
Name:DMITRIYEVA, YEKATERINA (HC)
Entity type:Individual
Prefix:
First Name:YEKATERINA
Middle Name:
Last Name:DMITRIYEVA
Suffix:
Gender:F
Credentials:HC
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:GORDIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1715 LONGVALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5117
Mailing Address - Country:US
Mailing Address - Phone:847-722-3733
Mailing Address - Fax:
Practice Address - Street 1:1715 LONGVALLEY DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-5117
Practice Address - Country:US
Practice Address - Phone:847-722-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach