MEDICARE: LAURYN KELLY SHERRY

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	106S00000X	Behavior Technician	RBT-24-382570

General Provider Information

NPI Number	:	1437015369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURYN KELLY SHERRY

Provider Business Mailing Address
First Line	:	21 BOULDER HILL PASS
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538
Country	:	US
Telephone Number	:	630-331-3667
Fax Number	:	630-338-0048

Provider Business Practice Location Address
First Line	:	21 BOULDER HILL PASS
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538
Country	:	US
Telephone Number	:	630-331-3667
Fax Number	:	630-338-0048

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “ LAURYN KELLY SHERRY ” Practice Location

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