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Search › Illinois › 225200000X

Justin Kelly, PTA

NPI 1841676806 · on the registry since 2015

Practice

Address
8434 Corcoran Rd
Willow Springs, IL 60480
Phone
(708) 467-0657
Fax
(708) 330-5046
Organisation at this address
O'Connor Foundation
Active Medical Supply Co.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
10

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2015-08-04

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