MEDICARE: MAYA HOWARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	071.022580	IL

General Provider Information

NPI Number	:	1114885423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYA HOWARD

Provider Business Mailing Address
First Line	:	736 W BUENA AVE APT 506
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-2203
Country	:	US
Telephone Number	:	847-686-0090
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 E GRAND AVE STE 500
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-3800
Country	:	US
Telephone Number	:	847-686-0090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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