Provider Demographics
NPI:1679737647
Name:YESKO, DAVID (PSYD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:YESKO
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 1:13011 S 104TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1500
Mailing Address - Country:US
Mailing Address - Phone:708-448-3300
Mailing Address - Fax:708-448-6972
Practice Address - Street 1:13011 S 104TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1500
Practice Address - Country:US
Practice Address - Phone:708-448-3300
Practice Address - Fax:708-448-6972
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007435103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical