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General NPI Number Information
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NPI Number | 1689221699
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Entity Type | Individual
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Provider Name | KELLI KEINATH
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Gender | Female
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 1140 N MCLEAN BLVD
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City | ELGIN
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State | IL
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Zip | 60123-1782
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Country | US
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Telephone | 847-695-3680
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Fax |
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Provider Business Mailing Address
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Address Line | 697 STEWART AVE
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City | NORTH AURORA
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State | IL
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Zip | 60542-9125
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Country | US
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Telephone | 630-770-2827
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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