Provider Demographics
NPI:1083624498
Name:MCINERNEY, JUDI A (PSY D)
Entity Type:Individual
Prefix:DR
First Name:JUDI
Middle Name:A
Last Name:MCINERNEY
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 CLARA AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9650
Mailing Address - Country:US
Mailing Address - Phone:312-510-7509
Mailing Address - Fax:630-850-2123
Practice Address - Street 1:7 SALT CREEK LN
Practice Address - Street 2:SUITE 206
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2927
Practice Address - Country:US
Practice Address - Phone:630-850-2120
Practice Address - Fax:630-850-2123
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical