Provider Demographics
NPI:1154763852
Name:MCGEE, KELLI MARIE
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:MARIE
Last Name:MCGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:MARIE
Other - Last Name:KRAUTMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:233 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4430
Mailing Address - Country:US
Mailing Address - Phone:630-373-8724
Mailing Address - Fax:
Practice Address - Street 1:307 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4012
Practice Address - Country:US
Practice Address - Phone:630-373-8724
Practice Address - Fax:630-837-8838
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist