Provider Demographics
NPI:1578385183
Name:GULATI, SHAIYNA KAUR
Entity type:Individual
Prefix:
First Name:SHAIYNA
Middle Name:KAUR
Last Name:GULATI
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 1:75 EXECUTIVE DR STE 403
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-8112
Mailing Address - Country:US
Mailing Address - Phone:630-448-8000
Mailing Address - Fax:630-448-8001
Practice Address - Street 1:75 EXECUTIVE DR STE 403
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8112
Practice Address - Country:US
Practice Address - Phone:630-448-8000
Practice Address - Fax:630-448-8001
Is Sole Proprietor?:No
Enumeration Date:2024-10-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178018703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional