MEDICARE: TAYA TOWNSEND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		IL

General Provider Information

NPI Number	:	1659205474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYA TOWNSEND

Provider Business Mailing Address
First Line	:	19150 KEDZIE AVE STE 208
Second Line	:
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-4541
Country	:	US
Telephone Number	:	312-478-8467
Fax Number	:	312-284-2375

Provider Business Practice Location Address
First Line	:	19150 KEDZIE AVE STE 208
Second Line	:
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-4541
Country	:	US
Telephone Number	:	312-478-8467
Fax Number	:	312-284-2375

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ TAYA TOWNSEND ” Practice Location

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