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General NPI Number Information
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NPI Number | 1750304051
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Entity Type | Individual
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Provider Name | KELLY SUE DOW DPT
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 1626 OGDEN AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2732
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Country | US
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Telephone | 630-724-0977
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Fax | 630-724-0978
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Provider Business Mailing Address
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Address Line | 1 WESTBROOK CORPORATE CTR STE 240
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City | WESTCHESTER
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State | IL
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Zip | 60154-5745
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Country | US
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Telephone | 708-236-2733
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070015114
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License Number State | IL
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