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General NPI Number Information
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NPI Number | 1336104934
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Entity Type | Individual
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Provider Name | KYLEE J LADD PA
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Gender | Female
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 1160 E OGDEN AVE STE 106
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City | NAPERVILLE
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State | IL
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Zip | 60563-2693
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Country | US
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Telephone | 331-226-0315
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Fax | 331-226-0315
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Provider Business Mailing Address
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Address Line | 3832 GRASSMERE RD
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City | NAPERVILLE
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State | IL
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Zip | 60564-8234
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Country | US
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Telephone | 802-782-7500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 055-0030279
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085-005152
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License Number State | IL
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