Individual
CHRISTOPHER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2525 KANEVILLE RD, GENEVA, IL 60134-2578
(630) 584-1411
(630) 513-2630
Mailing address
2525 KANEVILLE RD, GENEVA, IL 60134-2578
(630) 584-1411
(630) 513-2630
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-011747
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
753210
MEDICARE GROUP
IL
01
—
CF2064
RAILROAD GROUP
IL
Enumeration date
12/29/2005
Last updated
07/19/2010
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