Healthcare Provider Details

I. General information

NPI: 1669312963
Provider Name (Legal Business Name): EISHA VORA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MIDWEST RD STE 104
OAK BROOK IL
60523-1396
US

IV. Provider business mailing address

939 W NORTH AVE STE 750
CHICAGO IL
60642-7142
US

V. Phone/Fax

Practice location:
  • Phone: 224-520-4624
  • Fax:
Mailing address:
  • Phone: 224-520-4624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number071.022647
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: