Organization Active NPI

Jung Mi Yi, PSYD., LTD

  • Clinical Psychologist
  • Wauconda, IL
National Provider Identifier
1497580427
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
JUNG MI YI, PSYD., LTD
Practice address
401 Oak Grove Cir
Wauconda, IL 60084-3903
Phone
(224) 227-3764
NPI assigned
Sep 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jung Mi Yi, PSYDNPI 1326448226
Title
President
Phone
(224) 227-3761

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

401 Oak Grove Cir
Wauconda, IL 60084-3903

Mailing address

401 Oak Grove Cir
Wauconda, IL 60084-3903

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1497580427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 OAK GROVE CIR",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600843903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OAK GROVE CIR",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600843903",
            "telephone_number": "224-227-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNG MI YI, PSYD., LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-08",
        "status": "A",
        "authorized_official_last_name": "YI",
        "authorized_official_first_name": "JUNG MI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-227-3761",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauconda, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.