Provider Demographics
NPI:1861036303
Name:BYE TRUAX, KAYLEN MARJORIE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:KAYLEN
Middle Name:MARJORIE
Last Name:BYE TRUAX
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 1:619 SILVERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-1181
Mailing Address - Country:US
Mailing Address - Phone:847-977-7371
Mailing Address - Fax:
Practice Address - Street 1:619 SILVERSTONE DR
Practice Address - Street 2:
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-1181
Practice Address - Country:US
Practice Address - Phone:847-977-7371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.013322225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist