Provider Demographics
NPI:1497320261
Name:DRUEK, KYRA MYRALYNN (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:MYRALYNN
Last Name:DRUEK
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 DEEP WATER LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8504
Mailing Address - Country:US
Mailing Address - Phone:630-904-9070
Mailing Address - Fax:
Practice Address - Street 1:2156 DEEP WATER LN
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8504
Practice Address - Country:US
Practice Address - Phone:630-904-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.014202225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics