Individual
KELLY HOOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3528 W WALNUT ST, CHICAGO, IL 60624-1942
(312) 730-4411
Mailing address
3528 W WALNUT ST, CHICAGO, IL 60624-1942
(312) 730-4411
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/25/2016
Last updated
09/25/2016
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