MEDICARE: KAYLA SHANAE DALEY

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	106S00000X	Behavior Technician	RBT-26-513589	IL

General Provider Information

NPI Number	:	1356267587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA SHANAE DALEY

Provider Business Mailing Address
First Line	:	923 S NA WA TA AVE
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4145
Country	:	US
Telephone Number	:	224-762-9154
Fax Number	:

Provider Business Practice Location Address
First Line	:	923 S NA WA TA AVE
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4145
Country	:	US
Telephone Number	:	224-762-9154
Fax Number	:

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

Provider Enumeration Date	:	06/24/2026
Last Update Date	:	06/24/2026

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Directions to “ KAYLA SHANAE DALEY ” Practice Location

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