MR. DELOREAN MCKINNEY (NPI# 1891205605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891205605 |
| Entity Type | Individual |
| Full Name | MR. DELOREAN MCKINNEY |
| Credential | BEHAVIORAL HEALTH |
| Practice Address |
4031 Dayton Ave Mchenry IL 60050 |
| Mailing Address |
4031 W Dayton St Mchenry IL 60050-8377 |
| Practice Telephone | 8153441230 |
| Mailing Telephone | 8153441230 |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DSP | 9127 | 01 |
| Street Address |
4031 DAYTON AVE |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1992274971 | Lisa Luedtke | Counselor | 5342 West Elm Street, Mchenry, IL 60050 | 2018-11-19 |
| 1013402825 | Fox Ridge Medical Associates, LLC | Internal Medicine | 3633 Municipal Dr, Mchenry, IL 60050 | 2018-06-25 |
| 1700387065 | Richard Stacy Birmantas | Speech-Language Pathologist | 6515 West Route 120, Mchenry, IL 60050 | 2018-02-22 |
| 1659888774 | Kathleen Mather | Speech-Language Pathologist | 3502 Washington St, Mchenry, IL 60050 | 2018-01-10 |
| 1851810741 | Diana Park | Pharmacist | 2253 N. Richmond Rd., Mchenry, IL 60050 | 2017-09-12 |
| 1063931921 | Lauren M Young | Counselor | 4031 W. Dayton Street, Mchenery, IL 60050 | 2017-09-12 |
| 1376086264 | Elizabeth Kathleen Zacher | Social Worker | 4100 W Dayton Street, Mchenry, IL 60050 | 2016-11-23 |
| 1700332491 | Jasmine Elias | Social Worker | 4031 Dayton St, Mchenry, IL 60050 | 2016-09-01 |
| 1144776360 | Michal Jakub Kubiak | Internal Medicine | 4111 W. Lillian Street Apt. F, Mchenry, IL 60050 | 2016-08-28 |
| Find all providers in zip 60050 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194296582 | Joshua E Green | Psychologist | 2721 W Belmont Ave Apt 1, Chicago, IL 60618-5914 | 2018-12-10 |
| 1447598305 | Alison Lee May | Psychologist | 4736 Washington St, Skokie, IL 60076-2573 | 2013-01-27 |
| 1477818359 | Susan Elizabeth Reed | Psychologist | 2434 W Byron St, Chicago, IL 60618-3710 | 2012-07-07 |
| 1134392590 | Jennifer Lynne Klapatch | Psychologist | 928 W Eastwood Ave, Chicago, IL 60640-5108 | 2008-04-08 |
| 1285803114 | Michael E May | Psychologist | 208 Breeze St, Carterville, IL 62918-2358 | 2008-02-25 |
| 1386812782 | Vicky James | Psychologist | 11600 Francis Rd, Mokena, IL 60448-2440 | 2008-02-19 |
| 1700054988 | Erika Marie Winston | Psychologist | 3100 S Central Ave, Cicero, IL 60804-3956 | 2008-02-11 |
| 1245411156 | Trista D. Robinson | Psychologist | 100 Forest Pl, Unit P36, Oak Park, IL 60301-1145 | 2007-11-19 |
| 1942489315 | Emily Guinta | Psychologist | 3135 Concord Ln, Wadsworth, IL 60083-8938 | 2007-11-01 |
| 1629266945 | Gabriela I. Sierra | Psychologist | 828 Hannah Ave, Forest Park, IL 60130-2006 | 2007-10-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.