Basic Information
| Provider Information | |||||||||
| NPI: | 1255826814 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | YODER | ||||||||
| FirstName: | HAYLEY | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1114 DECLARATION DR | ||||||||
| Address2: | |||||||||
| City: | SAVOY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 618748731 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2 W ADAMS ST | ||||||||
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| City: | SULLIVAN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619511943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2177287353 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2018 | ||||||||
| LastUpdateDate: | 09/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 37-1410310 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.