Individual
JANET D KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
300 RIDGE RD, MUNSTER, IN 46321-1528
(219) 836-0027
(219) 836-0067
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-3251
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056003572
IL
225X00000X
Occupational Therapist
31003868A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01228322
MEDICARE RAILROAD
IN
Enumeration date
09/29/2006
Last updated
12/03/2013
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