Healthcare Provider Details

I. General information

NPI: 1669336590
Provider Name (Legal Business Name): NATASHA YANCEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 DALHART AVE
ROMEOVILLE IL
60446-1332
US

IV. Provider business mailing address

297 WATERBURY CIR
OSWEGO IL
60543-7920
US

V. Phone/Fax

Practice location:
  • Phone: 815-886-4343
  • Fax:
Mailing address:
  • Phone: 773-240-2585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: