DR. KELLY ANN KANE (NPI# 1861742264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861742264 |
| Entity Type | Individual |
| Full Name | DR. KELLY ANN KANE |
| Credential | PSYD |
| Practice Address |
611 W Park St Urbana IL 61801-2500 |
| Mailing Address |
611 W Park St Bwpc Urbana IL 61801-2500 |
| Practice Telephone | 2173833440 |
| Practice Fax Number | 2173260160 |
| Mailing Telephone | 2173836792 |
| Mailing Fax Number | 2173834752 |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2014-11-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 071008319 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265057392 | Kelly Elizabeth Kane | Chiropractor | 29767 Route 220, Athens, PA 18810-9103 | 2020-06-15 |
| 1912122730 | Kelly Ann Kane | Dietitian, Registered | 750 Washington St # 783, Boston, MA 02111-1526 | 2007-04-16 |
| 1497776579 | Kelly Rose Kane | Dermatology | 235 Shore Rd Ste C, Somers Point, NJ 08244-2655 | 2006-07-22 |
| 1437515657 | Kelly Kane | Physician Assistant | 1540 S Tamiami Trl, Suite 303, Sarasota, FL 34239-2921 | 2016-01-04 |
| 1205209897 | Kelly Moore Kane | Nurse Practitioner | 7700 Floyd Curl Dr, San Antonio, TX 78229-3902 | 2015-11-05 |
| 1932188364 | Kelly A Kane | Pediatrics | 800 S Logan Blvd, Suite 1200, Hollidaysburg, PA 16648-3050 | 2006-01-13 |
| Street Address |
611 W PARK ST |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831193416 | Mark L Saxton | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2005-06-10 |
| 1083214514 | Karissa Nelson | Physical Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-10-26 |
| 1720698756 | Justin Matthew Felix | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-04 |
| 1033729306 | Patricia Fairchild | Occupational Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-03 |
| 1851909782 | Shruti Agarwal | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-16 |
| 1396363321 | Muhammad Umair Rana | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-07 |
| 1740807817 | Salma Malik | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-06 |
| 1477171536 | Audrey T Lam | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1255959318 | Corbin Reid Mah | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1093332652 | Knika Sethi | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750703641 | Catherine M York | Clinical Neuropsychologist | 611 W. Park St., Neuropsychology, Urbana, IL 61801-2500 | 2014-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477183556 | Michelle Yvonne Kibby-faglier | Clinical Neuropsychologist | 285 Lake Indian Hills Dr, Carbondale, IL 62902-6184 | 2020-01-17 |
| 1003456708 | David Jackson | Clinical Neuropsychologist | 6 Parkway North Blvd, Deerfield, IL 60015-2522 | 2020-01-10 |
| 1649830159 | Natalie Berger | Clinical Neuropsychologist | 1645 W Jackson Blvd Ste 203, Chicago, IL 60612-3227 | 2019-06-17 |
| 1043877475 | Sarah Mailander Dyer | Clinical Neuropsychologist | 900 Royal Heights Rd Ste 14, Belleville, IL 62226-5457 | 2019-05-21 |
| 1639655632 | Julia Digangi | Clinical Neuropsychologist | 920 N York Rd, Hinsdale, IL 60521-2996 | 2018-07-13 |
| 1891211710 | Kenneth Vicencio | Clinical Neuropsychologist | 4100 Healthway Drive, Aurora, IL 60504 | 2017-08-22 |
| 1538690466 | Kathleen Ares | Clinical Neuropsychologist | 4440 W 95th, Suite 1200h, Oak Lawn, IL 60453 | 2017-03-22 |
| 1225575871 | Israel Gross | Clinical Neuropsychologist | 1934 W. Roscoe St., #4, Chicago, IL 60657 | 2017-01-20 |
| 1013462829 | Ann Westcot Jordan | Clinical Neuropsychologist | 21037 Benjamin Dr, Shorewood, IL 60404-0612 | 2016-08-22 |
| 1740638915 | Elizabeth Regina Tuminello Hartman | Clinical Neuropsychologist | 1875 Dempster St Ste 520, Park Ridge, IL 60068-1130 | 2016-05-29 |
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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.