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Jack Kelly, BCBA
NPI 1396383030 · on the registry since 2019
Practice
- Address
- 917 Sherwood Dr Ste 201
Lake Bluff, IL 60044 - Phone
- (877) 486-4140
- Organisation at this address
- Lake Forest Pediatric Associates, Ltd
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 118
Additional practice sites
- 1975 Mcdowell Rd. #101, Naperville, IL
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 106E00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-08-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois