Individual
KAITLYN S KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
300 MEMORIAL DR, CRYSTAL LAKE, IL 60014-6278
(815) 459-7110
(815) 459-2889
Mailing address
300 MEMORIAL DR STE 300, CRYSTAL LAKE, IL 60014-6273
(815) 459-7110
(815) 459-7138
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010544
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0406010544
—
IL
01
—
502720063
MEDICARE PTAN
IL
Enumeration date
06/13/2012
Last updated
02/19/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us