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NPI Code Detail

MEDICARE: KYNDAL COOTE

MEDICARE: KYNDAL COOTE
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
1104100000XSocial Worker150.114254IL

General Provider Information

NPI Number : 1568280683
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYNDAL COOTE
Provider Business Mailing Address
First Line : 1164 W MADISON ST UNIT 530
Second Line :
City : CHICAGO
State : IL
Zip : 60607-3802
Country : US
Telephone Number : 336-508-0029
Fax Number :
Provider Business Practice Location Address
First Line : 4621 N RAVENSWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4509
Country : US
Telephone Number : 773-413-9523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2024
Last Update Date : 09/27/2024

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Directions to “ KYNDAL COOTE ” Practice Location

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