Individual
KELLI LANE RODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
964 N 5TH AVE, BUILDING C, ST CHARLES, IL 60174-1204
(630) 484-4142
Mailing address
470 CHESTERFIELD LN, NORTH AURORA, IL 60542-9105
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008241
IL
Other
Enumeration date
09/13/2010
Last updated
08/06/2012
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