Individual
KELCY IRENE SUYDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
411 E WASHINGTON ST, EAST PEORIA, IL 61611-2663
(309) 282-6704
(309) 387-2340
Mailing address
507 E ARMSTRONG AVE, PEORIA, IL 61603-3201
(309) 686-1177
(309) 686-7722
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008424
IL
Other
Enumeration date
08/30/2012
Last updated
07/21/2022
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