Individual
KELLY CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6712 N CONVENT ST, BOURBONNAIS, IL 60914-1528
(815) 295-8300
(815) 295-8301
Mailing address
900 RAND RD STE 300, DES PLAINES, IL 60016-2359
(847) 324-3976
(847) 929-1154
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160-009012
IL
Other
Enumeration date
08/25/2021
Last updated
11/29/2021
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