Provider Demographics
NPI:1366969123
Name:KIEL, CHELSIE
Entity type:Individual
Prefix:MRS
First Name:CHELSIE
Middle Name:
Last Name:KIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 45C
Mailing Address - Street 2:
Mailing Address - City:GOLDEN EAGLE
Mailing Address - State:IL
Mailing Address - Zip Code:62036-9753
Mailing Address - Country:US
Mailing Address - Phone:618-363-0750
Mailing Address - Fax:
Practice Address - Street 1:100 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-1473
Practice Address - Country:US
Practice Address - Phone:618-498-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist