Healthcare Provider Details

I. General information

NPI: 1982523767
Provider Name (Legal Business Name): DELANEY BORST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 W 111TH ST STE 1
OAK LAWN IL
60453-5575
US

IV. Provider business mailing address

8104 ODELL AVE
BRIDGEVIEW IL
60455-1622
US

V. Phone/Fax

Practice location:
  • Phone: 708-634-0821
  • Fax:
Mailing address:
  • Phone: 630-864-0887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: