MEDICARE: LINDSEY KEHLENBRINK OTR/L

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	225X00000X	Occupational Therapist	056011925	IL

General Provider Information

NPI Number	:	1437685955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY KEHLENBRINK OTR/L

Provider Business Mailing Address
First Line	:	2619 N HALSTED ST
Second Line	:	#2
City	:	CHICAGO
State	:	IL
Zip	:	60614-2301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2619 N HALSTED ST
Second Line	:	#2
City	:	CHICAGO
State	:	IL
Zip	:	60614-2301
Country	:	US
Telephone Number	:	317-439-2870
Fax Number	:

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

Provider Enumeration Date	:	05/03/2017
Last Update Date	:	05/03/2017

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