Healthcare Provider Details

I. General information

NPI: 1285863480
Provider Name (Legal Business Name): BENJAMIN AARON PYYKKONEN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2580 FOXFIELD RD STE 201
SAINT CHARLES IL
60174-1409
US

IV. Provider business mailing address

1358 SANDCHERRY LN
WEST CHICAGO IL
60185-5973
US

V. Phone/Fax

Practice location:
  • Phone: 331-707-4031
  • Fax:
Mailing address:
  • Phone: 630-699-7499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number071.007708
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071.007708
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.007708
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: