Healthcare Provider Details

I. General information

NPI: 1306770664
Provider Name (Legal Business Name): TAYLER HOLLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13242 ILLINOIS RTE 59 STE 102
PLAINFIELD IL
60585
US

IV. Provider business mailing address

15358 DAN PATCH DR
PLAINFIELD IL
60544-2426
US

V. Phone/Fax

Practice location:
  • Phone: 779-234-9957
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: