Healthcare Provider Details

I. General information

NPI: 1912835570
Provider Name (Legal Business Name): MAYA PATEL M.S., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 IL ROUTE 22
FOX RIVER GROVE IL
60021-1905
US

IV. Provider business mailing address

4N612 CAMPTON CROSSINGS DR
ST CHARLES IL
60175-6543
US

V. Phone/Fax

Practice location:
  • Phone: 224-219-1924
  • Fax: 224-526-5156
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number242.018573
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: