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NPI Code Detail

MEDICARE: JENNIFER LYNN MCKAY PSYD

MEDICARE: JENNIFER LYNN MCKAY PSYD
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
1103TC0700XClinical Psychologist071008002IL

General Provider Information

NPI Number : 1649207945
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN MCKAY PSYD
Provider Business Mailing Address
First Line : 1120 E MAIN ST
Second Line : STE. 201
City : ST CHARLES
State : IL
Zip : 60174-2287
Country : US
Telephone Number : 630-377-6613
Fax Number : 630-377-6225
Provider Business Practice Location Address
First Line : 110 E COUNTRYSIDE PKWY
Second Line :
City : YORKVILLE
State : IL
Zip : 60560-1813
Country : US
Telephone Number : 630-553-1600
Fax Number : 630-553-7993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 07/09/2014

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