MEDICARE: KYLE GARIFO

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
1	101YP2500X	Professional Counselor	180005170	IL

General Provider Information

NPI Number	:	1134838063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE GARIFO

Provider Business Mailing Address
First Line	:	310 BOULDER DR
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-4442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 BOULDER DR
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-4442
Country	:	US
Telephone Number	:	847-971-9314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2022
Last Update Date	:	11/18/2022

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Directions to “ KYLE GARIFO ” Practice Location

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