MEDICARE: KAYLIE ANN REINGLASS MS

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	242005531	IL
2	235Z00000X	Speech-Language Pathologist	146015756	IL

General Provider Information

NPI Number	:	1568011518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLIE ANN REINGLASS MS

Provider Business Mailing Address
First Line	:	3080 WARBLER PL
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-1267
Country	:	US
Telephone Number	:	847-814-3080
Fax Number	:

Provider Business Practice Location Address
First Line	:	1864 JOHNS DR
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60025-1657
Country	:	US
Telephone Number	:	847-707-6744
Fax Number	:

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

Provider Enumeration Date	:	09/11/2019
Last Update Date	:	04/02/2021

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Directions to “ KAYLIE ANN REINGLASS MS” Practice Location

Language	Start Address	Practice Location

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