CAROLYN KELLY (NPI# 1619264041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619264041 |
| Entity Type | Individual |
| Full Name | CAROLYN KELLY |
| Credential | D.P.M. |
| Practice Address |
396 Remington Blvd Ste 370 Bolingbrook IL 60440-4302 |
| Practice Telephone | 6304186601 |
| Practice Fax Number | 6303122223 |
| Mailing Telephone | 6304186601 |
| Mailing Fax Number | 6303122223 |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-08-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 135000752 | IL | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016.005524 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
016005524 | IL | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 256 Tudor Court, Bolingbrook, IL 604402056 | 6302940810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407197072 | Carolyn Ann Kelly | Nurse Practitioner | 11 Osborne St, Danbury, CT 06810-5918 | 2013-03-07 |
| 1639283286 | Carolyn Downey Kelly | Nurse Practitioner | 1 Barnes Jew Hosp Plz, Saint Louis, MO 63110 | 2006-08-19 |
| 1649739350 | Carolyn Kelly | Counselor | 3445 S Sheridan Rd, Tulsa, OK 74145-1105 | 2019-03-13 |
| 1316399421 | Carolyn Kelly | Social Worker | 676 N Saint Clair St, Suite 2140, Chicago, IL 60611-2927 | 2016-07-13 |
| 1639503345 | Carolyn V Kelly | Physical Therapist | 4700 Gilbert Ave, Suite 51, Western Springs, IL 60558-1753 | 2013-08-29 |
| 1376981209 | Carolyn Marion Kelly | Registered Nurse | 1711 Holmes Dr Sw, Conyers, GA 30094-4725 | 2013-06-13 |
| 1912174913 | Carolyn Kelly | Nurse Practitioner | 801 6th St S, St Petersburg, FL 33701-4816 | 2008-05-09 |
| 1740328863 | Carolyn Kelly | Physical Therapist | 181 Patricia Genova Drive, Eastern Rehabilitation Network (5th Floor), Newington, CT 06111 | 2007-02-01 |
| 1427062264 | Carolyn Jean Kelly | Internal Medicine | 3350 La Jolla Village Dr, Mail Code 111h, San Diego, CA 92161-0002 | 2006-07-28 |
| 1164463741 | Carolyn S Kelly | Counselor | 107 Thomason Blvd, Goose Creek, SC 29445-2945 | 2006-06-08 |
| Street Address |
396 REMINGTON BLVD STE 370 |
| City | BOLINGBROOK |
| State | IL |
| Zip Code | 60440-4302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141251 | Derick Dermatology, LLC | Dermatology | 239 Remington Boulevard, Suite 225, Bolingbrook, IL 60440 | 2020-07-16 |
| 1851949150 | Rachel Nicole Weis | Student in an Organized Health Care Education/Training Program | 777 Falconridge Way, Bolingbrook, IL 60440 | 2019-08-29 |
| 1578072815 | Onna Ford-kendrick | Nurse Practitioner | 151 E. Briarcliff Rd, -, Bolingbrook, IL 60440 | 2017-09-28 |
| 1891245213 | Megan Lotarski | Specialist/Technologist | 6 Copper Ct, Bolingbrook, IL 60440 | 2016-10-10 |
| 1144775800 | Mitchell Quill | Chiropractor | 550 E Boughton Rd Ste 150, Bolingbrook, IL 60440 | 2016-08-23 |
| 1477914125 | Alessia L. Elerby | Specialist | 128 S Cass Ave, Westmont, IL 60440 | 2016-03-09 |
| 1982073821 | Melissa Perkins | Counselor | 511 Preston Drive, Bolingbrook, IL 60440 | 2015-09-22 |
| 1821467754 | Advanced Patient Care, LLC. | Pharmacy | 335-337 Remington Blvd., Bolingbrook, IL 60440 | 2015-09-22 |
| 1770998262 | Adventist Bolingbrook Hospital | Internal Medicine | 420 S Schmidt, Ste 230, Bolingbrook, IL 60440 | 2014-06-24 |
| 1467864512 | Alice II Salons | Specialist | 311 Quadr,., Bolingbrook, IL 60440 | 2014-05-23 |
| Find all providers in zip 60440 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114214236 | Aaron K Kim | Podiatrist | 396 Remington Blvd Ste 141, Bolingbrook, IL 60440-4306 | 2011-07-10 |
| 1396811824 | Bolingbrook Foot Specialists Ltd | Podiatrist | 454 W Boughton Road, Bolingbrook, IL 60440-1378 | 2006-11-27 |
| 1255987707 | Aaron Kim Dpm S.c | Podiatrist | 396 Remington Blvd, Bolingbrook, IL 60440-4302 | 2019-08-12 |
| 1275880270 | Farah Parveen Mohammed | Podiatrist | 215 Remington Blvd, Suite A2, Bolingbrook, IL 60440-3656 | 2012-08-08 |
| 1215076617 | Jeffrey M Mackler | Podiatrist | 454 W Boughton Rd, Suite A Jeffrey M Mackler Dpm, Bolingbrook, IL 60440-1378 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154930485 | Mid America Foot & Ankle Specialist Illinois LLC | Podiatrist | 2003 Montgomery Rd Ste 108109, Aurora, IL 60504-9078 | 2020-07-22 |
| 1265040026 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 4121 Fairview Ave Ste 102, Downers Grove, IL 60515-2266 | 2020-07-17 |
| 1316563612 | Jacob Tilsley | Podiatrist | 610 S Maple Ave Ste 2250, Oak Park, IL 60304-1093 | 2020-06-22 |
| 1033738547 | C James Anderson Dpm LLC | Podiatrist | 1000 Eleven S Ste 3a, Columbia, IL 62236-1077 | 2020-04-14 |
| 1386263895 | C James Anderson Dpm LLC | Podiatrist | 717 Insight Ave Ste 100, O Fallon, IL 62269-2193 | 2020-04-14 |
| 1821631367 | Dr Christine Heck PC | Podiatrist | 111 N Wabash Ave Ste 1914, Chicago, IL 60602-2968 | 2019-10-28 |
| 1013562578 | Bishoy Atef Botros | Podiatrist | 820 S Damen Ave Fl 7, Chicago, IL 60612-3728 | 2019-08-01 |
| 1538623947 | Steven B Overpeck Dpm PC | Podiatrist | 25520 S Pheasant Ln Unit K, Channahon, IL 60410-8808 | 2019-01-30 |
| 1366916355 | Center for Foot and Ankle Surgery Ltd | Podiatrist | 654 W Veterans Pkwy Ste D, Yorkville, IL 60560-2510 | 2019-01-14 |
| 1497224950 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 1288 S Us Highway 12, Fox Lake, IL 60020-1950 | 2018-11-14 |
| Find all providers with the same taxonomy | ||||
| City | BOLINGBROOK |
| Zip Code | 60440 |
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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.