Provider Demographics
NPI:1841329539
Name:VARGAS-GATZA, CLAUDIA (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:VARGAS-GATZA
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 1:7 HOLLYCOURT TER
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-1213
Mailing Address - Country:US
Mailing Address - Phone:773-406-6497
Mailing Address - Fax:847-438-6540
Practice Address - Street 1:7 HOLLYCOURT TER
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-1213
Practice Address - Country:US
Practice Address - Phone:773-406-6497
Practice Address - Fax:847-438-6540
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
IL146.009222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCV48560401POtherEI CREDENTIAL FOR DT
IL146.009222OtherIL STATE LICENSE FOR SLP
ILCV48560401POtherEARLY INTERVENTION CREDENTIAL FOR SLP