Healthcare Provider Details

I. General information

NPI: 1073157582
Provider Name (Legal Business Name): HALEY YOUNG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2019
Last Update Date: 01/24/2026
Certification Date: 01/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 COLUMBIA CIR
NORTH AURORA IL
60542-1812
US

IV. Provider business mailing address

838 COLUMBIA CIR
NORTH AURORA IL
60542-1812
US

V. Phone/Fax

Practice location:
  • Phone: 630-448-0545
  • Fax: 630-326-8652
Mailing address:
  • Phone: 630-330-3659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.007329
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: