Provider Demographics
NPI:1316958325
Name:YAPELLI, FREDERICK J (PHD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:J
Last Name:YAPELLI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 W NORTH AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2136
Mailing Address - Country:US
Mailing Address - Phone:630-279-2660
Mailing Address - Fax:630-279-2694
Practice Address - Street 1:579 W NORTH AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2136
Practice Address - Country:US
Practice Address - Phone:630-279-2660
Practice Address - Fax:630-279-2694
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71002143103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2215255OtherBLUE SHIELD
ILK19053Medicare ID - Type Unspecified