MEDICARE: HAYLEY YODER NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	37-1410310	IL

General Provider Information

NPI Number	:	1255826814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY YODER NP-C

Provider Business Mailing Address
First Line	:	1114 DECLARATION DR
Second Line	:
City	:	SAVOY
State	:	IL
Zip	:	61874-8731
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 W ADAMS ST
Second Line	:
City	:	SULLIVAN
State	:	IL
Zip	:	61951-1943
Country	:	US
Telephone Number	:	217-728-7353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2018
Last Update Date	:	04/29/2024

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Directions to “ HAYLEY YODER NP-C” Practice Location

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