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General NPI Number Information
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NPI Number | 1497297667
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Entity Type | Individual
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Provider Name | KATELYN MARIE DERRIG OTR
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Gender | Female
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 5820 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60634-2616
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Country | US
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Telephone | 773-685-8482
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Fax |
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Provider Business Mailing Address
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Address Line | 5 S BUSSE RD
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City | MT PROSPECT
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State | IL
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Zip | 60056-2901
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Country | US
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Telephone | 224-935-7399
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.011751
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056.011751
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License Number State | IL
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