MEDICARE: KAYLA LANG OTD, 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	225XP0200X	Pediatric Occupational Therapist	015504	IL
2	225X00000X	Occupational Therapist	015504	IL

General Provider Information

NPI Number	:	1508713520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA LANG OTD, OTR/L

Provider Business Mailing Address
First Line	:	2056 W 75TH PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-5701
Country	:	US
Telephone Number	:	773-571-2992
Fax Number	:

Provider Business Practice Location Address
First Line	:	2056 W 75TH PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-5701
Country	:	US
Telephone Number	:	773-571-2992
Fax Number	:

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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