Healthcare Provider Details

I. General information

NPI: 1821734229
Provider Name (Legal Business Name): KRISTA STARKEY DEVELOPMENTAL THERAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N GROVE ST
COLFAX IL
61728-8937
US

IV. Provider business mailing address

102 N GROVE ST
COLFAX IL
61728-8937
US

V. Phone/Fax

Practice location:
  • Phone: 773-396-4221
  • Fax:
Mailing address:
  • Phone: 773-396-4221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: