Provider Demographics
NPI:1790026193
Name:KAEPPEL, BAILEY ELIZABETH (BS REHAB PSYCH)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:ELIZABETH
Last Name:KAEPPEL
Suffix:
Gender:F
Credentials:BS REHAB PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 W HIGHLAND AVE
Mailing Address - Street 2:3-8
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5382
Mailing Address - Country:US
Mailing Address - Phone:608-630-3407
Mailing Address - Fax:
Practice Address - Street 1:4677 N VIRGINIA AVE
Practice Address - Street 2:1N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2953
Practice Address - Country:US
Practice Address - Phone:708-341-8222
Practice Address - Fax:312-929-0324
Is Sole Proprietor?:No
Enumeration Date:2013-03-09
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker