MEDICARE: KAYLEE COLLINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146.017860	IL

General Provider Information

NPI Number	:	1093525479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE COLLINS

Provider Business Mailing Address
First Line	:	1202 BRIDGE PARK DR
Second Line	:
City	:	ALTON
State	:	IL
Zip	:	62002-7420
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 E LORENA AVE
Second Line	:
City	:	WOOD RIVER
State	:	IL
Zip	:	62095-2123
Country	:	US
Telephone Number	:	618-254-4354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	12/10/2025

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Directions to “ KAYLEE COLLINS ” Practice Location

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