KELLY FARELL (NPI# 1962064709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962064709 |
| Entity Type | Individual |
| Full Name | KELLY FARELL |
| Practice Address |
103 N Haven Rd Ste 7 Elmhurst IL 60126-2973 |
| Mailing Address |
103 N Haven Rd Ste 7 Elmhurst IL 60126-2973 |
| Practice Telephone | 6308322111 |
| Mailing Telephone | 4192662051 |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363A00000X | Physician Assistant | 085007028 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
103 N HAVEN RD STE 7 |
| City | ELMHURST |
| State | IL |
| Zip Code | 60126-2973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154931434 | Andrew D Chastain | Physical Therapy Assistant | 188 N. Industrial Drive, Suite 112, Elmhurst, IL 60126 | 2020-08-03 |
| 1407464472 | Kevin M. Dunn | Physical Therapy Assistant | 188 N, Industrial Dr, Suite 112, Elmhurst, IL 60126 | 2020-07-16 |
| 1699236414 | Rosario Garcia | Nurse Practitioner | 1200 York St, Elmhurst, IL 60126 | 2019-03-26 |
| 1003390857 | Lauren M Gorski | Physical Therapist | 275 N. York Rd, Suite 300, Elmhurst, IL 60126 | 2018-09-18 |
| 1073041240 | Kyle Patrick Harmon | Dentist | 127 W Vallette St, Elmhurst, IL 60126 | 2017-05-31 |
| 1083065031 | Mariah Lynn Kyro | Behavioral Analyst | 650 W. Grand Avenue Suite 207, Elmhurst, IL 60126 | 2016-06-30 |
| 1841661261 | Randi N. Rockell | Nurse Practitioner | 155 E. Brush Hill Rd., Elmhurst Memorial Hospital, Elmhurst, IL 60126 | 2015-10-12 |
| 1508254897 | Soles Therapy Services Corp | Speech-Language Pathologist | 627 N York Street, Unit E, Elmhurst, IL 60126 | 2015-01-08 |
| 1629466560 | Amy J Pawlik | Physical Therapist | 263 N. York Rd., Suite 200, Elmhurst, IL 60126 | 2014-12-30 |
| 1265771349 | Ladawna Goering | Nurse Practitioner | 133 E Brush Hill, Suite 310, Elmhurst, IL 60126 | 2013-02-08 |
| Find all providers in zip 60126 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013552595 | Kendall Kilander | Physician Assistant | 133 E Brush Hill Rd Ste 310, Elmhurst, IL 60126-5662 | 2019-11-08 |
| 1912470360 | Fauzia Bagum | Physician Assistant | 4036 Aske St Fl 3, Elmhurst, NY 11373-1748 | 2019-01-08 |
| 1407326382 | Meredith Brackett | Physician Assistant | 333 E Webster Ave, Elmhurst, IL 60126-3636 | 2018-12-04 |
| 1952871519 | Reda Benani | Physician Assistant | 7426 Woodside Ave, Apt 3r, Elmhurst, NY 11373-1137 | 2018-11-27 |
| 1801395082 | Shreya Amin | Physician Assistant | 8337 Saint James Ave Apt 5a, Elmhurst, NY 11373-3771 | 2018-02-02 |
| 1366974891 | Ulyana Nepokulchytska | Physician Assistant | 386 N York St Ste 100, Elmhurst, IL 60126-2365 | 2017-04-03 |
| 1285185520 | Alexandra Gold | Physician Assistant | 9424 58th Ave, Elmhurst, NY 11373-5149 | 2016-10-21 |
| 1750651980 | Imran Shahzad | Physician Assistant | 4255 80th St Apt 3g, Elmhurst, NY 11373-3041 | 2012-01-04 |
| 1538478417 | Mariah Esposito | Physician Assistant | 79-01 Broadway Elmhurst Hospital, Department of Radiology E1-85, Elmhurst, NY 11373 | 2010-09-27 |
| 1306051974 | Jill Zembera | Physician Assistant | 9406 59th Ave Ste E-9, Elmhurst, NY 11373-5151 | 2007-05-14 |
| Find all providers in ELMHURST | ||||
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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.