Individual provider · Type 1 NPI

Mary Kelly, PT

Pediatric Physical Therapist · St. Charles, IL

NPI number 1073590212 Active

Practice location

3381 W Main St Ste 1
St. Charles, IL 60175-1008

Fax (630) 549-0512

Specialties and licenses

TaxonomyCodeLicense
Pediatric Physical Therapist Primary 2251P0200X070-011761 (IL)

Pediatric Physical Therapist: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical th…

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About NPI 1073590212

Mary Kelly, PT's National Provider Identifier is 1073590212, issued on Dec 29, 2005. The primary taxonomy on file is Pediatric Physical Therapist (2251P0200X), and the practice location is in St. Charles, IL. The record was last updated on Jun 15, 2022.