Provider Demographics
NPI:1336367606
Name:VANMETER, JEFFREY BRIAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:BRIAN
Last Name:VANMETER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 N SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-3862
Mailing Address - Country:US
Mailing Address - Phone:877-443-7030
Mailing Address - Fax:630-983-0162
Practice Address - Street 1:3033 OGDEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1976
Practice Address - Country:US
Practice Address - Phone:877-443-7030
Practice Address - Fax:630-983-0162
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006312103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932120OtherBLUE CROSS BLUE SHIELD
ILK10876Medicare ID - Type Unspecified
IL9932120OtherBLUE CROSS BLUE SHIELD