Provider Demographics
NPI:1407599186
Name:HALBIG, KATELYN (OT)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:HALBIG
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:KAMMINGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:803-812-3656
Mailing Address - Fax:
Practice Address - Street 1:300 E 109TH AVE STE B
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8693
Practice Address - Country:US
Practice Address - Phone:219-662-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007655A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist