KELLY L KLIEBE (NPI# 1215561600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215561600 |
| Entity Type | Individual |
| Full Name | KELLY L KLIEBE |
| Other Name | KELLY L DIEHL |
| Practice Address |
325 Illinois Rt 2 Dixon IL 61021-9118 |
| Mailing Address |
106 E Indian Cove Dr Oregon IL 61061-9320 |
| Practice Telephone | 8152846611 |
| Mailing Telephone | 8159089919 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
197387 | TN | Nursing Service Providers |
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
0141404877 | IL | Nursing Service Providers |
| Street Address |
325 ILLINOIS RT 2 |
| City | DIXON |
| State | IL |
| Zip Code | 61021-9118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225237233 | Maria D Ruch | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2007-07-11 |
| 1417558719 | Michael Kenneth Buza | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-11-03 |
| 1275133514 | Stephanie Mae Roman | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-10-27 |
| 1003416520 | Rae Lynn Metzler8 | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-10-26 |
| 1477160935 | Anne Fridh | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-09-29 |
| 1255948634 | Ashley Nicole Edwards | Social Worker | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-09-29 |
| 1184230856 | Olimpia Bernal | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-09-18 |
| 1538772496 | Sierra Nicole Elsbury | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-08-28 |
| 1659984953 | Caitlin Joy Refatllari | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-08-26 |
| 1811500390 | Tyler Inghram | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101420 | Alissa Nichole Thompson | Registered Nurse | 2541 W Belden Ave Apt 1, Chicago, IL 60647-0482 | 2020-07-09 |
| 1548892565 | Sonja K Negrean | Registered Nurse | 280 Shuman Blvd, Naperville, IL 60563-8492 | 2020-02-07 |
| 1134772353 | Theresa Jane Debord | Registered Nurse | 5835 State Route 154 # Address2, Pinckneyville, IL 62274-3418 | 2019-07-17 |
| 1740740653 | Cherise C Rosen | Registered Nurse | 110 Frank Lloyd Wright Ln, Oak Park, IL 60302-2616 | 2019-03-25 |
| 1821589706 | Virginie Nyancho | Registered Nurse | 1336 Court Leona, Hanover Park, IL 60133-5419 | 2018-05-25 |
| 1861848681 | Merry Carlson | Registered Nurse | 1120 N Farnsworth Ave Apt 1d, Aurora, IL 60505-2049 | 2016-05-11 |
| 1801210273 | Robie Victoria Hughes | Registered Nurse | 310 W Losey Street, Scott Air Force Base, IL 62225 | 2014-02-06 |
| 1215360763 | Debra A Foppe | Registered Nurse | 19125 State Route 127, Carlyle, IL 62231-5303 | 2013-08-19 |
| 1871817742 | Bente Clausen | Registered Nurse | 715 Lake St Ste 720, Oak Park, IL 60301-1416 | 2010-03-22 |
| 1477887032 | Susan Leann Lear | Registered Nurse | 1001 N Market St Ste 101, Mount Carmel, IL 62863-1945 | 2009-09-29 |
| Find all providers with the same taxonomy | ||||
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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.