Healthcare Provider Details

I. General information

NPI: 1689580516
Provider Name (Legal Business Name): LAUREN TRACY KELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S MCHENRY AVE STE F
CRYSTAL LAKE IL
60014-7487
US

IV. Provider business mailing address

1043 ARBOR CT
MT PROSPECT IL
60056-4476
US

V. Phone/Fax

Practice location:
  • Phone: 815-526-3750
  • Fax: 815-526-3440
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178033010
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: