Provider Demographics
NPI:1821480997
Name:FLOARKE, KAITLIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:FLOARKE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:SPEICHINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1525 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:RED BUD
Mailing Address - State:IL
Mailing Address - Zip Code:62278-1374
Mailing Address - Country:US
Mailing Address - Phone:618-282-6251
Mailing Address - Fax:
Practice Address - Street 1:1525 LOCUST ST
Practice Address - Street 2:
Practice Address - City:RED BUD
Practice Address - State:IL
Practice Address - Zip Code:62278-1374
Practice Address - Country:US
Practice Address - Phone:618-282-6251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.010749225XP0200X, 225X00000X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation