Individual
NATHAN WAYNE YEAGER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
901 W MORTON AVE, SUITE 16A, JACKSONVILLE, IL 62650-3146
(217) 245-4640
(217) 245-4642
Mailing address
715 MAGNOLIA DR, CHATHAM, IL 62629-1129
(217) 391-4314
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UNIV OF NORTH DAKOTA
SCHOOL
—
Enumeration date
03/27/2006
Last updated
07/08/2007
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