Provider Demographics
NPI:1811698780
Name:BOREL, GAYLE K (MA, AAS SLPA)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:K
Last Name:BOREL
Suffix:
Gender:F
Credentials:MA, AAS SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 S KIRK AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5143
Mailing Address - Country:US
Mailing Address - Phone:163-063-8472
Mailing Address - Fax:
Practice Address - Street 1:211 W CHICAGO AVE STE 112
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3357
Practice Address - Country:US
Practice Address - Phone:163-063-8472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL217.0004012355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant