Healthcare Provider Details

I. General information

NPI: 1619871860
Provider Name (Legal Business Name): MEGAN ALEXANDRA LA FERLITA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDER LAFERLITA

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 DORIS AVE
JOLIET IL
60433-2569
US

IV. Provider business mailing address

2276 PEMBRIDGE DR
LAKE IN THE HILLS IL
60156-6413
US

V. Phone/Fax

Practice location:
  • Phone: 815-727-8710
  • Fax:
Mailing address:
  • Phone: 224-422-9918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070029332
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: