Active NPI
David Yesko, PSY.D.
- Clinical Psychologist
- Palos Park, IL
National Provider Identifier
1679737647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.007435
- Practice address
- 13011 S 104TH Ave Ste 200
Palos Park, IL 60464-1500 - Phone
- (708) 448-3300
- Fax
- (708) 448-6972
- NPI assigned
- Jul 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.007435 | IL | Primary |
Addresses
Primary practice location
13011 S 104TH Ave Ste 200
Palos Park, IL 60464-1500
Mailing address
13011 S 104TH Ave Ste 200
Palos Park, IL 60464-1500
Phone (708) 448-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.007435 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miracare Neuro Behavioral Health, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Palos Heights, IL
- NPI 1649329251
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216252800000",
"number": "1679737647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13011 S 104TH AVE STE 200",
"city": "PALOS PARK",
"state": "IL",
"postal_code": "604641500",
"telephone_number": "708-448-3300",
"fax_number": "708-448-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13011 S 104TH AVE STE 200",
"city": "PALOS PARK",
"state": "IL",
"postal_code": "604641500",
"telephone_number": "708-448-3300",
"fax_number": "708-448-6972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YESKO",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-17",
"last_updated": "2008-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.007435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palos Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.