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NPI Code Detail

MEDICARE: CAITLIN ROSE CADWALDER

MEDICARE: CAITLIN ROSE CADWALDER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1063350072
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN ROSE CADWALDER
Provider Business Mailing Address
First Line : 3000 SUNRISE CIR APT 303
Second Line :
City : LAKE ORION
State : MI
Zip : 48360-2386
Country : US
Telephone Number : 847-293-4862
Fax Number :
Provider Business Practice Location Address
First Line : 2160 S 1ST AVE
Second Line :
City : MAYWOOD
State : IL
Zip : 60153-3328
Country : US
Telephone Number : 888-584-7888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “ CAITLIN ROSE CADWALDER ” Practice Location

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