Healthcare Provider Details

I. General information

NPI: 1740430008
Provider Name (Legal Business Name): VARSHA PATEL MSCCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 N OAKLAWN AVE
ELMHURST IL
60126-1827
US

IV. Provider business mailing address

532 N OAKLAWN AVE
ELMHURST IL
60126-1827
US

V. Phone/Fax

Practice location:
  • Phone: 630-803-4838
  • Fax: 630-501-1672
Mailing address:
  • Phone: 630-803-4838
  • Fax: 630-501-1672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146005216
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: