Provider Demographics
NPI:1801430178
Name:BARRETT, SKYLER LOUISE (DT)
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:LOUISE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 S CLARK ST UNIT 404
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1763
Mailing Address - Country:US
Mailing Address - Phone:260-409-6478
Mailing Address - Fax:
Practice Address - Street 1:3048 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6624
Practice Address - Country:US
Practice Address - Phone:260-409-6478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist