MEDICARE: KATELYN MCNELLIS THERAPY PPLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1467310284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATELYN MCNELLIS THERAPY PPLC

Provider Business Mailing Address
First Line	:	22875 SARA SPRINGS DR
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-9227
Country	:	US
Telephone Number	:	708-955-9563
Fax Number	:

Provider Business Practice Location Address
First Line	:	22875 SARA SPRINGS DR
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-9227
Country	:	US
Telephone Number	:	708-955-9563
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	KATELYN MCNELLIS
Credential	:	LCPC
Telephone Number	:	708-955-9563

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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