Provider Demographics
NPI:1649594383
Name:PATEL, SHEFALIE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHEFALIE
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 W BLACKHAWK ST
Mailing Address - Street 2:UNIT 1106
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-2510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:860 W BLACKHAWK ST
Practice Address - Street 2:UNIT 1106
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-2510
Practice Address - Country:US
Practice Address - Phone:317-514-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010421235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist