DR. JEFFREY SAUNDERS KELLOGG (NPI# 1093740862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093740862 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY SAUNDERS KELLOGG |
| Credential | PSY.D |
| Practice Address |
3412 S Illinois Ave Carbondale IL 62903-8362 |
| Practice Telephone | 6184574488 |
| Practice Fax Number | 6184578844 |
| Mailing Telephone | 6184574488 |
| Mailing Fax Number | 6184578844 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2015-03-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
071003739 | IL | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
071003739 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861532350 | Jeffrey D Kellogg | Family Medicine | 45 Maddex Dr, Shepherdstown, WV 25443-4322 | 2007-02-07 |
| 1215925011 | Jeffrey J Kellogg | Physician Assistant | 510 North St, Pittsfield, MA 01201-5493 | 2005-10-06 |
| 1083657084 | Jeffrey L. Kellogg | Family Medicine | 4545 Sergeant Rd, Sioux City, IA 51106-4706 | 2006-06-14 |
| Street Address |
3412 S ILLINOIS AVE |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62903-8362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255711438 | Karla K. Fehr | Psychologist | 3412 S Illinois Ave, Carbondale, IL 62903-8362 | 2015-06-03 |
| 1700975612 | Gloria C Debeljuk | Social Worker | 3412 S Illinois Ave, Carbondale, IL 62903-8362 | 2006-10-11 |
| 1043223613 | Matthew Eric Denis | Psychologist | 3412 S Illinois Ave, Carbondale, IL 62903-8362 | 2006-08-14 |
| 1235145426 | Donald Allen Doty | Psychologist | 3412 S Illinois Ave, Carbondale, IL 62903-8362 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447625918 | Integrative Spine Care, LLC | Pain Medicine | 364 Lake Indian Hills Circle, Carbondale, IL 62903 | 2015-12-09 |
| 1811949910 | Devon G Barnes | Nurse Anesthetist, Certified Registered | 35 Albany Road, Suite C, Carbondale, IL 62903 | 2006-05-17 |
| 1316282130 | Centerstone of Illinois, Inc | Community/Behavioral Health | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2012-12-05 |
| 1861009128 | Ashley Pruett | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-30 |
| 1477167823 | Zachary Woosley | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-03 |
| 1215553110 | Margaret K Henry | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-06-17 |
| 1053934489 | Matthew Picchietti | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-05-20 |
| 1487287835 | Lyndsey Wideman | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-02-13 |
| 1124659024 | Matthew Leigh | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-01-29 |
| 1447890199 | Nicholas Foy | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-01-10 |
| Find all providers in zip 62903 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255711438 | Karla K. Fehr | Psychologist | 3412 S Illinois Ave, Carbondale, IL 62903-8362 | 2015-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902441603 | Jasmine Dominique Jones | Psychologist | 19041 Willow Ave, Country Club Hills, IL 60478-5740 | 2019-11-18 |
| 1912483074 | Kristina Kochanova | Psychologist | 3380 Lacrosse Lane, Suites 106-107, Naperville, IL 60564 | 2018-07-12 |
| 1235647470 | Laurie Gayes Thompson | Psychologist | 225 E Chicago Ave # 2, Chicago, IL 60611-2991 | 2018-01-22 |
| 1558874891 | Claire Ashling Coyne | Psychologist | 225 E Chicago Ave # 10b, Chicago, IL 60611-2991 | 2017-11-08 |
| 1659721967 | Micah Ioffe | Psychologist | 1300 W Belmont Ave Ste 501, Chicago, IL 60657 | 2016-06-16 |
| 1609243856 | Humboldt Behavioral Health Group | Psychologist | 3317 W Le Moyne St, Chicago, IL 60651-2452 | 2015-08-24 |
| 1003156928 | Early Autism Project, Inc. | Psychologist | 599 Falling Waters Way, Lindenhurst, IL 60046-1703 | 2013-03-01 |
| 1659610491 | Alexandra M Psihogios | Psychologist | 1110 W Columbia Ave, Apt 1n, Chicago, IL 60626-4522 | 2013-02-13 |
| 1265781934 | Anthony Thomas Vesco | Psychologist | 225 E Chicago Ave # 10a, Chicago, IL 60611-2991 | 2012-09-10 |
| 1891044038 | Irma Porcic Khelghati | Psychologist | 1200 Harger Rd Ste 600, Oak Brook, IL 60523-1820 | 2012-09-04 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.