Provider Demographics
NPI:1649263823
Name:YERKES, MARY ANGELA (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANGELA
Last Name:YERKES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 SOUTHWEST HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1200
Mailing Address - Country:US
Mailing Address - Phone:708-986-5168
Mailing Address - Fax:844-464-0739
Practice Address - Street 1:11900 SOUTHWEST HWY STE 202
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1200
Practice Address - Country:US
Practice Address - Phone:708-986-5168
Practice Address - Fax:844-464-0739
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004207103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635445OtherBLUE CROSS PIN
IL212282Medicare ID - Type Unspecified