Individual
KAITLIN ELIZABETH BRUNSVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. OTR/L
Contact information
Practice address
2515 N CLARK ST., CHICAGO, IL 60614
(312) 227-4000
Mailing address
333 S. DESPLAINES ST, #606, CHICAGO, IL 60661-5509
(248) 425-4968
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008883
IL
225XP0200X
Pediatric Occupational Therapist
056008883
IL
Other
Enumeration date
12/28/2009
Last updated
08/28/2023
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