Healthcare Provider Details

I. General information

NPI: 1639090046
Provider Name (Legal Business Name): PAIGE ELIZABETH VONDRASEK MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 HARVEST GATE RD
LAKE IN THE HILLS IL
60156-4877
US

IV. Provider business mailing address

1040 BEAU BRUMMEL CT
SLEEPY HOLLOW IL
60118-1811
US

V. Phone/Fax

Practice location:
  • Phone: 847-957-7070
  • Fax:
Mailing address:
  • Phone: 610-438-2020
  • Fax: 888-388-8764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.018816
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: