Healthcare Provider Details

I. General information

NPI: 1154065332
Provider Name (Legal Business Name): KAYLEA GUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E SUPERIOR ST STE 9-900
CHICAGO IL
60611-4494
US

IV. Provider business mailing address

545 N MCCLURG CT UNIT 2302
CHICAGO IL
60611-3880
US

V. Phone/Fax

Practice location:
  • Phone: 312-503-7975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125087125
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: