Healthcare Provider Details

I. General information

NPI: 1821679739
Provider Name (Legal Business Name): ISABELLA PATRICE TARLACH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date: 06/12/2026
Reactivation Date: 07/20/2026

III. Provider practice location address

915 NATIONAL PKWY STE 915-60
SCHAUMBURG IL
60173-5348
US

IV. Provider business mailing address

827 N PRESIDENT ST
WHEATON IL
60187-4363
US

V. Phone/Fax

Practice location:
  • Phone: 224-548-8813
  • Fax:
Mailing address:
  • Phone: 630-363-4406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90611
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: