MEDICARE: DR. GARY R DEC PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	071-003329	IL

General Provider Information

NPI Number	:	1528137684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY R DEC PSY.D.

Provider Business Mailing Address
First Line	:	1S115 GARDENER WAY
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-2802
Country	:	US
Telephone Number	:	630-470-0237
Fax Number	:

Provider Business Practice Location Address
First Line	:	1S115 GARDENER WAY
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-2802
Country	:	US
Telephone Number	:	630-470-0237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	02/09/2026

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