Healthcare Provider Details

I. General information

NPI: 1922995018
Provider Name (Legal Business Name): KAYLYN A SCHWICHTENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 E CHICAGO AVE
CHICAGO IL
60611-2009
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 312-951-9700
  • Fax: 312-951-6989
Mailing address:
  • Phone: 630-575-6250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070029220
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: