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Individual

BARBARA KELLOGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
857 CENTER CT UNIT D, SHOREWOOD, IL 60431-8520
(815) 730-1818
Mailing address
15249 LAWNDALE AVE, MIDLOTHIAN, IL 60445-3763
(708) 389-2124

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
57001435
IL

Other

Enumeration date
08/11/2006
Last updated
07/08/2007
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