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NPI Code Detail

MEDICARE: KAILA PELLEGRINI

MEDICARE: KAILA PELLEGRINI
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
1225X00000XOccupational Therapist056.012747IL

General Provider Information

NPI Number : 1821566837
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAILA PELLEGRINI
Provider Business Mailing Address
First Line : 10100 S BELL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60643-1906
Country : US
Telephone Number : 773-401-8574
Fax Number :
Provider Business Practice Location Address
First Line : 3709 N KEDZIE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-4503
Country : US
Telephone Number : 773-377-5492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2018
Last Update Date : 11/07/2018

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Directions to “ KAILA PELLEGRINI ” Practice Location

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