Provider Demographics
NPI:1932492378
Name:VAIYA, SHERENAZ PYARALI (MACCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SHERENAZ
Middle Name:PYARALI
Last Name:VAIYA
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 N 5TH AVE
Mailing Address - Street 2:BUILDING C
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1204
Mailing Address - Country:US
Mailing Address - Phone:630-443-8202
Mailing Address - Fax:630-443-8205
Practice Address - Street 1:964 N 5TH AVE
Practice Address - Street 2:BUILDING C
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1204
Practice Address - Country:US
Practice Address - Phone:630-443-8202
Practice Address - Fax:630-443-8205
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.004981235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist