Mary Kelly
Physical Therapist - Pediatrics
2525 Kaneville Rd
Geneva
, Illinois 60134
Mary Kelly
Physical Therapist - Pediatrics
2525 Kaneville Rd
Geneva
, Illinois 60134
(630) 513-2630
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About
Features
Specialties
- Physical Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Mary Kelly
- 2011 Dean St Ste B
- St Charles, IL
- Zip : 60174-4802
- Fax : (630) 513-2630
- Phone : (630) 584-1411
Second Address
- Mary Kelly
- 2525 Kaneville Rd
- Geneva, IL
- Zip : 60134
- Fax : (630) 513-2630
- Phone : (630) 584-1411
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251P0200X | Physical Therapist - Pediatrics | 070-011761 | IL |
National Provider Identifier
| NPI | 1073590212 |
|---|---|
| Provider Name | Mary Kelly |
| First Address | St Charles, IL 60174-4802 |
| Second Address | Geneva, IL 60134 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/12/2005 |
| Last Update Date | 11/06/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.