Healthcare Provider Details

I. General information

NPI: 1801430178
Provider Name (Legal Business Name): SKYLER LOUISE BARRETT DT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3048 N MILWAUKEE AVE
CHICAGO IL
60618-6624
US

IV. Provider business mailing address

850 S CLARK ST UNIT 404
CHICAGO IL
60605-1763
US

V. Phone/Fax

Practice location:
  • Phone: 260-409-6478
  • Fax:
Mailing address:
  • Phone: 260-409-6478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: