Individual
JORDAN LEE KELLGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1860 W WINCHESTER RD STE 108, LIBERTYVILLE, IL 60048-5312
(847) 573-9486
Mailing address
1860 W WINCHESTER RD STE 108, LIBERTYVILLE, IL 60048-5312
(847) 573-9486
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
001846
IA
235Z00000X
Speech-Language Pathologist
Primary
146.009599
IL
Other
Enumeration date
05/27/2008
Last updated
12/11/2008
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