MEDICARE: KELSEY VEILLEUX LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	178014453	IL

General Provider Information

NPI Number	:	1104388420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY VEILLEUX LPC

Provider Business Mailing Address
First Line	:	175 E HAWTHORN PKWY STE 235
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-1454
Country	:	US
Telephone Number	:	847-737-8768
Fax Number	:	847-859-5885

Provider Business Practice Location Address
First Line	:	4615 E STATE ST STE 202
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2158
Country	:	US
Telephone Number	:	847-868-3435
Fax Number	:	847-859-5885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2019
Last Update Date	:	04/04/2019

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Directions to “ KELSEY VEILLEUX LPC” Practice Location

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