Provider Demographics
NPI:1447935218
Name:HOFFMEISTER, JACLYN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JACLYN
Middle Name:
Last Name:HOFFMEISTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1274
Mailing Address - Country:US
Mailing Address - Phone:630-717-5911
Mailing Address - Fax:630-445-4072
Practice Address - Street 1:1801 N MILL ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1274
Practice Address - Country:US
Practice Address - Phone:630-717-5911
Practice Address - Fax:630-445-4072
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical