Provider Demographics
NPI:1407037682
Name:YACKER, JUDITH GAIL (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:GAIL
Last Name:YACKER
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1773 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2315
Mailing Address - Country:US
Mailing Address - Phone:847-831-4081
Mailing Address - Fax:
Practice Address - Street 1:1773 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2315
Practice Address - Country:US
Practice Address - Phone:847-831-4081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist