Healthcare Provider Details

I. General information

NPI: 1851709166
Provider Name (Legal Business Name): JOSHUA R YEAGER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 N ELM ST STE 207
HINSDALE IL
60521-3637
US

IV. Provider business mailing address

908 N ELM ST STE 207
HINSDALE IL
60521-3637
US

V. Phone/Fax

Practice location:
  • Phone: 630-850-2120
  • Fax: 630-850-2123
Mailing address:
  • Phone: 630-850-2120
  • Fax: 630-850-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071008862
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: