Healthcare Provider Details

I. General information

NPI: 1992620181
Provider Name (Legal Business Name): MARISSA PALMEJAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 MACOM DR STE 103
NAPERVILLE IL
60564-9360
US

IV. Provider business mailing address

5440 N SHERIDAN RD APT 401
CHICAGO IL
60640-8730
US

V. Phone/Fax

Practice location:
  • Phone: 630-585-7337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146029139
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: