MEDICARE: GABRIELLE ALEXIS MIKOLAY

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1134865066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE ALEXIS MIKOLAY

Provider Business Mailing Address
First Line	:	6S525 NAPER BLVD
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-6059
Country	:	US
Telephone Number	:	630-890-5206
Fax Number	:

Provider Business Practice Location Address
First Line	:	1516 LEGACY CIR STE 100
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-1253
Country	:	US
Telephone Number	:	331-249-6626
Fax Number	:

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

Provider Enumeration Date	:	05/12/2022
Last Update Date	:	07/02/2024

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Directions to “ GABRIELLE ALEXIS MIKOLAY ” Practice Location

Language	Start Address	Practice Location

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