Ellsworth, Kermalene Marie

Ellsworth, Kermalene Marie is an sole proprietor health care provider with primary practice located at 5006 Memory Trl , Mchenry IL 60051-7778. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Ellsworth, Kermalene Marie can be contacted via phone (847) 497-3264.

Contact Information

Primary practice address
5006 Memory Trl Mchenry IL 60051-7778
Phone: (847) 497-3264
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 160.004012 Illinois

Profile Details

NPI number 1306107065
LBN Legal business name Ellsworth, Kermalene Marie
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2012
Last updated May 30th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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