Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mikaela Fahey

Individual provider Physical Therapy Assistant · NPI 1023691268

Mikaela Fahey is a Physical Therapy Assistant in Glen Ellyn, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2021
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Practice location Address checks out

875 Roosevelt Rd
Glen Ellyn, IL 60137-6101
Phone: (630) 933-1500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 160.008635 (IL)

Record details

NPI number1023691268
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 5, 2021
Last updated in NPPESMay 5, 2021
Certification dateMay 5, 2021
Mailing address875 Roosevelt Rd, Glen Ellyn, IL 60137-6101

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