Healthcare Provider Details

I. General information

NPI: 1447935218
Provider Name (Legal Business Name): JACLYN HOFFMEISTER PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N MILL ST
NAPERVILLE IL
60563-1274
US

IV. Provider business mailing address

1801 N MILL ST
NAPERVILLE IL
60563-1274
US

V. Phone/Fax

Practice location:
  • Phone: 630-717-5911
  • Fax: 630-445-4072
Mailing address:
  • Phone: 630-717-5911
  • Fax: 630-445-4072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.010985
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: