Provider Demographics
NPI:1083258420
Name:CHURCHILL, CAITLIN PAIGE
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:PAIGE
Last Name:CHURCHILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 N KNOLLWOOD DR APT C
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-5747
Mailing Address - Country:US
Mailing Address - Phone:618-581-9959
Mailing Address - Fax:
Practice Address - Street 1:1072 N KNOLLWOOD DR APT C
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-5747
Practice Address - Country:US
Practice Address - Phone:618-581-9959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist