Provider Demographics
NPI:1942971692
Name:PHILBRICK, KAYLA ARIANNA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ARIANNA
Last Name:PHILBRICK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 SAN MATEO DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-8453
Mailing Address - Country:US
Mailing Address - Phone:708-417-1767
Mailing Address - Fax:
Practice Address - Street 1:863 CENTER CT UNIT D
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60404-8512
Practice Address - Country:US
Practice Address - Phone:815-730-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056014451225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist