MEDICARE: KAYLA PAYE MS, 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	5201009432	MI
2	225X00000X	Occupational Therapist	056011395	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	056011395	OTHER	IL	ILLINOIS OCCUPATIONAL THERAPY LICENSE
2	5201009432	OTHER	MI	MICHIGAN OCCUPATIONAL THERAPY LICENSE

General Provider Information

NPI Number	:	1689163537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA PAYE MS, OTR/L

Provider Business Mailing Address
First Line	:	1901 W GEORGE ST APT CH
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4182
Country	:	US
Telephone Number	:	810-358-9360
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 W GEORGE ST APT CH
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4182
Country	:	US
Telephone Number	:	810-358-9360
Fax Number	:

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

Provider Enumeration Date	:	05/07/2018
Last Update Date	:	07/05/2023

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