KAYLA RENE VANDERWALL (NPI# 1164840922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164840922 |
| Entity Type | Individual |
| Full Name | KAYLA RENE VANDERWALL |
| Credential | PA-C |
| Practice Address |
1200 S York St Ste 3280 Elmhurst IL 60126-5638 |
| Practice Telephone | 6306466020 |
| Mailing Telephone | 6306466020 |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2019-11-20 |
| NPI Deactivation Date | 11/06/2019 |
| NPI Reactivation Date | 2019-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
085007328 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 231 Noordewier Hall, Grand Rapids, MI 495464417 | 2197439368 |
| Street Address |
1200 S YORK ST STE 3280 |
| City | ELMHURST |
| State | IL |
| Zip Code | 60126-5638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154931434 | Andrew D Chastain | Physical Therapy Assistant | 188 N. Industrial Drive, Suite 112, Elmhurst, IL 60126 | 2020-08-03 |
| 1407464472 | Kevin M. Dunn | Physical Therapy Assistant | 188 N, Industrial Dr, Suite 112, Elmhurst, IL 60126 | 2020-07-16 |
| 1699236414 | Rosario Garcia | Nurse Practitioner | 1200 York St, Elmhurst, IL 60126 | 2019-03-26 |
| 1003390857 | Lauren M Gorski | Physical Therapist | 275 N. York Rd, Suite 300, Elmhurst, IL 60126 | 2018-09-18 |
| 1073041240 | Kyle Patrick Harmon | Dentist | 127 W Vallette St, Elmhurst, IL 60126 | 2017-05-31 |
| 1083065031 | Mariah Lynn Kyro | Behavioral Analyst | 650 W. Grand Avenue Suite 207, Elmhurst, IL 60126 | 2016-06-30 |
| 1841661261 | Randi N. Rockell | Nurse Practitioner | 155 E. Brush Hill Rd., Elmhurst Memorial Hospital, Elmhurst, IL 60126 | 2015-10-12 |
| 1508254897 | Soles Therapy Services Corp | Speech-Language Pathologist | 627 N York Street, Unit E, Elmhurst, IL 60126 | 2015-01-08 |
| 1629466560 | Amy J Pawlik | Physical Therapist | 263 N. York Rd., Suite 200, Elmhurst, IL 60126 | 2014-12-30 |
| 1265771349 | Ladawna Goering | Nurse Practitioner | 133 E Brush Hill, Suite 310, Elmhurst, IL 60126 | 2013-02-08 |
| Find all providers in zip 60126 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1336651512 | Elizabeth Danielle Most | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2017-10-28 |
| 1487042057 | Keith Kriesberg | Physician Assistant | 133 E Brush Hill Rd, Suite 200, Elmhurst, IL 60126-5659 | 2015-01-05 |
| 1649677121 | Czarina Alonzo | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2014-11-26 |
| 1700282803 | Susan R Jahn | Physician Assistant | 360 W Butterfield Rd, #160, Elmhurst, IL 60126-5068 | 2014-11-17 |
| 1376948190 | Nicole Foster | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2014-10-23 |
| 1821401316 | Orthopedic Specialists, S.c. | Physician Assistant | 360 W Butterfield Rd, #160, Elmhurst, IL 60126-5068 | 2014-06-03 |
| 1740527845 | Artem Pinkhasov | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2013-01-09 |
| 1467733386 | Patrick Lee | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2011-09-06 |
| 1114212453 | Magdalena Balkiewicz | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2011-06-15 |
| Find all providers in ELMHURST | ||||
Please comment or provide details below to improve the information on KAYLA RENE VANDERWALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.