Individual
KYLIE KATHLEEN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
8 S MICHIGAN AVE STE 1700, CHICAGO, IL 60603-3353
(312) 346-6230
Mailing address
2200 S MAIN ST STE 200, LOMBARD, IL 60148-5365
(312) 554-5184
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
056014722
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056014722
OCCUPATIONAL THERAPY LICENSE
IL
Enumeration date
10/21/2022
Last updated
06/26/2023
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