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General NPI Number Information
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NPI Number | 1851606495
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Entity Type | Individual
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Provider Name | KELLY ERIN O'NEILL DC
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Gender | Female
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 24W500 MAPLE AVE SUITE 105
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City | NAPERVILLE
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State | IL
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Zip | 60540-6055
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Country | US
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Telephone | 630-428-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 1833 N HUDSON AVE APARTMENT E
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City | CHICAGO
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State | IL
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Zip | 60614-7984
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Country | US
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Telephone | 843-469-5644
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3574
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038012154
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License Number State | IL
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