Healthcare Provider Details

I. General information

NPI: 1184539934
Provider Name (Legal Business Name): SHREYA KAMANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 PARK ST STE 100
NAPERVILLE IL
60563-8477
US

IV. Provider business mailing address

1543 WOODLAND LN
BOLINGBROOK IL
60490-3272
US

V. Phone/Fax

Practice location:
  • Phone: 630-884-5761
  • Fax:
Mailing address:
  • Phone: 630-506-0259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-496996
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: