Basic Information
| Provider Information | |||||||||
| NPI: | 1417362823 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YAGER | ||||||||
| FirstName: | DEBORAH | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1890 SILVER CROSS BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW LENOX | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604519524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159009060 | ||||||||
| FaxNumber: | 8157178794 | ||||||||
| Practice Location | |||||||||
| Address1: | 1890 SILVER CROSS BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW LENOX | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604519524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159009060 | ||||||||
| FaxNumber: | 8157178794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2014 | ||||||||
| LastUpdateDate: | 03/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 209006834 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.