Individual
KELLY SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
3082 CATON FARM RD, JOLIET, IL 60435-1455
(815) 577-9936
(815) 577-9938
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056006106
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056006106
LICENSE
IL
01
—
P01085945
MEDICARE RAILROAD
IL
Enumeration date
07/24/2006
Last updated
01/15/2025
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