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General NPI Number Information
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NPI Number | 1093651531
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Entity Type | Individual
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Provider Name | KELSEY CHERYL RODEHORST L. AC
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Gender | Female
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 60 REVERE DR STE 907
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City | NORTHBROOK
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State | IL
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Zip | 60062-1581
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Country | US
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Telephone | 224-213-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 1422 W CATALPA AVE
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City | CHICAGO
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State | IL
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Zip | 60640-1212
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Country | US
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Telephone | 208-721-8992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198.011986
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License Number State | IL
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