Healthcare Provider Details

I. General information

NPI: 1417362823
Provider Name (Legal Business Name): DEBORAH YAGER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6195 MARCELLA BLVD
HOBART IN
46342-0040
US

IV. Provider business mailing address

1890 SILVER CROSS BLVD
NEW LENOX IL
60451-9524
US

V. Phone/Fax

Practice location:
  • Phone: 219-942-7100
  • Fax:
Mailing address:
  • Phone: 815-900-9060
  • Fax: 815-717-8794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209006834
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: