Kylie Kathleen Carroll, OTR/L

Primary specialty

Mental Health Occupational TherapistTaxonomy code 225XM0800X

License

056014722 Issued in IL

Practice address

8 S Michigan Ave Ste 1700
Chicago, IL 60603-3353

Phone

(312) 346-6230

NPI assigned

Oct 21, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1083331987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 S MAIN ST STE 200",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485365",
            "telephone_number": "312-554-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 S MICHIGAN AVE STE 1700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033353",
            "telephone_number": "312-346-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KYLIE",
        "middle_name": "KATHLEEN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-21",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "IL",
            "license": "056014722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY LICENSE",
            "identifier": "056014722",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarroll@envisionunlimited.org",
            "affiliation": "Y",
            "endpointDescription": "Company email",
            "affiliationName": "Envision Unlimited",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "8 S Michigan Ave Ste 1700",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606033353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jodi Lee Carroll, MS OTR/L
• Julia Carroll, OTR/L
• Kaelyn Carroll, RN, CNM
• Katherine Carroll, M.D.
• Kathryn Kelly Carroll, LCSW
• Laurie Gold Carroll, DPT
• Mary K Carroll
• Mary Katherine Carroll, DNP, APRN, FNP-BC
• Nicole Carroll
• Nora Carroll

• Mental Health Occupational Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.