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General NPI Number Information
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NPI Number | 1093589699
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Entity Type | Individual
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Provider Name | SHAUNTAI P TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 11/14/2023
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 2948 ARTESIAN RD STE 112
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City | NAPERVILLE
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State | IL
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Zip | 60564-8559
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Country | US
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Telephone | 630-428-7890
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Fax | 630-428-7891
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Provider Business Mailing Address
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Address Line | 1333 S WABASH AVE UNIT 1711
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City | CHICAGO
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State | IL
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Zip | 60605-2628
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Country | US
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Telephone | 312-796-1315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178.019459
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License Number State | IL
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