Healthcare Provider Details

I. General information

NPI: 1003615501
Provider Name (Legal Business Name): KAYLA HALL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S PAULINA ST STE 403
CHICAGO IL
60612-3806
US

IV. Provider business mailing address

939 W WASHINGTON BLVD APT U415
CHICAGO IL
60607-2263
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5495
  • Fax: 312-942-5727
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number125.087747
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: