Healthcare Provider Details

I. General information

NPI: 1356252464
Provider Name (Legal Business Name): GILLIAN CAIRO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 SOUTH WOLCOTT AVE
CHICAGO IL
60612
US

IV. Provider business mailing address

1893 MCCRAREN RD
HIGHLAND PARK IL
60035-2226
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056027119
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: