Provider Demographics
NPI:1942456041
Name:ESHEL, MAYA (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:ESHEL
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 W JULIA CT
Mailing Address - Street 2:APT. #2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4013
Mailing Address - Country:US
Mailing Address - Phone:512-569-5709
Mailing Address - Fax:
Practice Address - Street 1:2714 W JULIA CT
Practice Address - Street 2:APT. #2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-4013
Practice Address - Country:US
Practice Address - Phone:512-569-5709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242-000701235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist