MEDICARE: KYLIE ANNE WHELAN DPT

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	225100000X	Physical Therapist		SC
2	225100000X	Physical Therapist	1378156	TX

General Provider Information

NPI Number	:	1164108254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE ANNE WHELAN DPT

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14999 PRESTON RD STE 108C
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-9138
Country	:	US
Telephone Number	:	214-231-4154
Fax Number	:	469-672-5520

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

Provider Enumeration Date	:	06/23/2023
Last Update Date	:	05/27/2025

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