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Individual

KAITLIN MILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
1675 DEMPSTER ST FL 3, PARK RIDGE, IL 60068-1110
(847) 723-4532
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011719
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
056011719
ILLINOIS PROFESSIONAL LICENSE
IL
Enumeration date
01/30/2020
Last updated
12/19/2023
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