Provider Demographics
NPI:1518785773
Name:GAFFKE, MAUREEN MARY
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:MARY
Last Name:GAFFKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 CLEMENTI LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-8578
Mailing Address - Country:US
Mailing Address - Phone:630-254-8807
Mailing Address - Fax:
Practice Address - Street 1:1000 5TH ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-7005
Practice Address - Country:US
Practice Address - Phone:630-551-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL546087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist