Provider Demographics
NPI:1770045692
Name:KAYALI, LILA
Entity type:Individual
Prefix:
First Name:LILA
Middle Name:
Last Name:KAYALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16435 NEWCASTLE WAY
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-6022
Mailing Address - Country:US
Mailing Address - Phone:708-328-0644
Mailing Address - Fax:
Practice Address - Street 1:1434 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2374
Practice Address - Country:US
Practice Address - Phone:630-286-0026
Practice Address - Fax:847-908-7541
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst