Healthcare Provider Details

I. General information

NPI: 1992949523
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHOLOGICAL AND SPEECH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1047 S YORK RD
ELMHURST IL
60126-5121
US

IV. Provider business mailing address

707 RIDGEVIEW ST
DOWNERS GROVE IL
60516-3930
US

V. Phone/Fax

Practice location:
  • Phone: 630-852-7336
  • Fax: 630-852-8177
Mailing address:
  • Phone: 630-852-7336
  • Fax: 630-852-8177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071005206
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146001511
License Number StateIL

VIII. Authorized Official

Name: DR. MARIA STEWART
Title or Position: SOLE MEMBER
Credential: PSY.D. - SPEECH THER
Phone: 630-852-7336