Healthcare Provider Details

I. General information

NPI: 1225786510
Provider Name (Legal Business Name): KARA ROSE SERRITELLI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 11/04/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 N ARLINGTON HEIGHTS RD SUITE 107
ARLINGTON HEIGHTS IL
60004
US

IV. Provider business mailing address

4031 W DAYTON ST
MCHENRY IL
60050-8377
US

V. Phone/Fax

Practice location:
  • Phone: 224-206-5001
  • Fax:
Mailing address:
  • Phone: 815-344-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: