Provider Demographics
NPI:1801911102
Name:MCKINLEY, DOUGLAS (PSYD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:MCKINLEY
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 1:1811 W DIEHL RD
Mailing Address - Street 2:STE 700
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9086
Mailing Address - Country:US
Mailing Address - Phone:630-983-0600
Mailing Address - Fax:630-983-3590
Practice Address - Street 1:1811 W DIEHL RD
Practice Address - Street 2:STE 700
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9086
Practice Address - Country:US
Practice Address - Phone:630-983-0600
Practice Address - Fax:630-983-3590
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
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