Individual provider · Type 1 NPI

Kiley Russell

Developmental Therapist · Chicago, IL

NPI number 1679347363 Active

Practice location

5100 S Dorchester Ave
Chicago, IL 60615-4118

Call (773) 966-5039 Map

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1679347363

Kiley Russell's National Provider Identifier is 1679347363, issued on Nov 13, 2023. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Chicago, IL. The record was last updated on Nov 13, 2023.