Healthcare Provider Details

I. General information

NPI: 1770411258
Provider Name (Legal Business Name): MAEGAN JENKINS PSYD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 DUNHAM RD STE 55
ST CHARLES IL
60174-1490
US

IV. Provider business mailing address

525 DUNHAM RD STE 55
ST CHARLES IL
60174-1490
US

V. Phone/Fax

Practice location:
  • Phone: 630-464-7990
  • Fax: 630-429-9419
Mailing address:
  • Phone: 630-464-7990
  • Fax: 630-429-9419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MAEGAN JENKINS
Title or Position: OWNER
Credential: PSY.D.
Phone: 630-464-7990