MEDICARE: DR. KELLY SANTOYO, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TC2200X	Clinical Child & Adolescent Psychologist
2	103TH0100X	Health Service Psychologist
3	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1558172866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. KELLY SANTOYO, PLLC

Provider Business Mailing Address
First Line	:	1225 LONGFORD CIR
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-4829
Country	:	US
Telephone Number	:	224-236-2336
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 LONGFORD CIR
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-4829
Country	:	US
Telephone Number	:	224-236-2336
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KELLY SANTOYO
Credential	:	PSYD
Telephone Number	:	224-236-2336

Provider Enumeration Date	:	01/16/2025
Last Update Date	:	12/12/2025

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