Healthcare Provider Details

I. General information

NPI: 1265337216
Provider Name (Legal Business Name): BRENDA XU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 BEISNER RD
ELK GROVE VILLAGE IL
60007-3475
US

IV. Provider business mailing address

325 E CHICAGO ST APT 1
ELGIN IL
60120-6599
US

V. Phone/Fax

Practice location:
  • Phone: 847-640-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146018868
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: