Keller, Kimberly A.

Keller, Kimberly A. is an individual health care provider with primary practice located at 1111 Trinity Ln Suite 111, Bloomington IL 61704-8111. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Keller, Kimberly A. can be contacted via phone (309) 663-6461.

Contact Information

Primary practice address
1111 Trinity Ln Suite 111 Bloomington IL 61704-8111
Phone: (309) 663-6461
Fax: (309) 661-4666
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 056004609 Illinois

Profile Details

NPI number 1720279409
LBN Legal business name Keller, Kimberly A.
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2007
Last updated Mar 1st, 2019 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1720279409 NPPES
Illinois Other STATE LICENSE 056004609

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