KELLY M INGRAM (NPI# 1649894130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649894130 |
| Entity Type | Individual |
| Full Name | KELLY M INGRAM |
| Practice Address |
38229 N North Ave Beach Park IL 60087-1662 |
| Practice Telephone | 8476502823 |
| Mailing Telephone | 8476502823 |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-06-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023178191 | Kelly Ingram | Speech-Language Pathologist | Arizona State University Speech and Hearing, 975 S. Myrtle Lattie Coor Hall 2324, Tempe, AZ 85287-0102 | 2006-12-11 |
| 1174185326 | Kelly Danean Ingram | Case Manager/Care Coordinator | 907 W Caddo St, Cleveland, OK 74020-4201 | 2019-07-08 |
| Street Address |
38229 N NORTH AVE |
| City | BEACH PARK |
| State | IL |
| Zip Code | 60087-1662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982268017 | Michael Donavan Wilson | Counselor | 200 North Lewis, Waukegan, IL 60087 | 2019-04-24 |
| 1114412160 | David B Fuentes | Specialist/Technologist | 2904 Wall Ave, Waukegan, IL 60087 | 2018-06-22 |
| 1578912713 | Fulton Family Dental, Ltd. | Dentist | 1308 Sunset Ave., Waukegan, IL 60087 | 2016-06-08 |
| 1902852825 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3124 N Lewis Ave, Waukegan, IL 60087 | 2006-05-25 |
| 1396723565 | Daram H Reddy Md | Psychiatry & Neurology | 609 Greenwood Ave, Waukegan, IL 60087 | 2006-01-06 |
| 1609200328 | Rosa Margaret Uriostegui | Interpreter | 2117 Edgewood Rd, Waukegan, IL 60087-1442 | 2013-08-29 |
| 1518390871 | Mary Sol Enriquez | Developmental Therapist | 11307 W Edgewood Rd, Beach Park, IL 60087-1526 | 2013-08-09 |
| 1467735209 | Kelly A. Holverson | Speech-Language Pathologist | 38286 N Geraghty Ave, Beach Park, IL 60087-1748 | 2011-09-27 |
| 1487669594 | Walgreen Co | Pharmacy | 39023 N Green Bay Rd, Beach Park, IL 60087-1978 | 2006-07-29 |
| 1568744787 | Carol Comstock | Pharmacist | 39023 N Green Bay Rd, Beach Park, IL 60087-1978 | 2011-09-14 |
| Find all providers in zip 60087 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | 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 Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518390871 | Mary Sol Enriquez | Developmental Therapist | 11307 W Edgewood Rd, Beach Park, IL 60087-1526 | 2013-08-09 |
| 1174828248 | Robin Jean Kieffer | Developmental Therapist | 39266 N North Ave, Beach Park, IL 60099-3780 | 2011-01-20 |
| 1548414048 | Sumer Porter | Developmental Therapist | 39649 N Warren Ln, Beach Park, IL 60083-3051 | 2008-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003413568 | Amy Rohan | Developmental Therapist | 17545 Mulberry Ave, Tinley Park, IL 60487-6163 | 2020-10-07 |
| 1992302954 | Vannetta C Thompson | Developmental Therapist | 2247 Gunderson Ave Apt 2, Berwyn, IL 60402-5147 | 2020-10-02 |
| 1477150506 | Quanita Crawford | Developmental Therapist | 3734 W Cortland St Apt 303, Chicago, IL 60647-7565 | 2020-10-01 |
| 1740897412 | Angela Perry | Developmental Therapist | 521 Eden Park Dr, Rantoul, IL 61866-1507 | 2020-09-28 |
| 1235746975 | Dominique Scott | Developmental Therapist | 5342 S Wells St, Chicago, IL 60609-6219 | 2020-09-27 |
| 1003429820 | Adrienne C Latronica | Developmental Therapist | 9865 Cordoba Ct Apt 2b, Orland Park, IL 60462-3190 | 2020-08-31 |
| 1669083424 | Lindsay Miner | Developmental Therapist | 2272 W Leland Ave # 1e, Chicago, IL 60625-2006 | 2020-08-13 |
| 1851901672 | Gretchen Susanne Biggerstaff | Developmental Therapist | 1706 S Hancock St, Mc Leansboro, IL 62859-1996 | 2020-08-06 |
| 1205446549 | Rene Yvonne Green | Developmental Therapist | 14425 E Blue Ridge Dr, Effingham, IL 62401-7168 | 2020-08-02 |
| 1306455357 | Noel Elizabeth Ryall | Developmental Therapist | 9123 Baldwin Dr, Machesney Park, IL 61115-1715 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | BEACH PARK |
| Zip Code | 60087 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.