Provider Demographics
NPI:1861246852
Name:PAQUETTE, TIMOTHY (PHD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:PAQUETTE
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 1:1979 N MILL ST STE 204
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8472
Mailing Address - Country:US
Mailing Address - Phone:630-474-1006
Mailing Address - Fax:833-218-8811
Practice Address - Street 1:1979 N MILL ST STE 204
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8472
Practice Address - Country:US
Practice Address - Phone:630-474-1006
Practice Address - Fax:833-218-8811
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007092103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical