Healthcare Provider Details

I. General information

NPI: 1477482016
Provider Name (Legal Business Name): DR. KAMARA TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4247 S PRAIRIE AVE APT 1N
CHICAGO IL
60653-3283
US

IV. Provider business mailing address

4247 S PRAIRIE AVE APT 1N
CHICAGO IL
60653-3283
US

V. Phone/Fax

Practice location:
  • Phone: 224-778-0389
  • Fax:
Mailing address:
  • Phone: 224-778-0389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: