Provider Demographics
NPI:1417405622
Name:PFEIFFER, KAYLA (MS)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:PFEIFFER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 RIVER BEND DR
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-5381
Mailing Address - Country:US
Mailing Address - Phone:815-573-2588
Mailing Address - Fax:
Practice Address - Street 1:22265 S 80TH AVE
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9786
Practice Address - Country:US
Practice Address - Phone:815-469-2309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.013843235Z00000X
IL242004050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist