Kelly M Supataraporn (NPI# 1083982078, PAC ID# 2769601251) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OCCUPATIONAL THERAPY.
| Nation Provider ID (NPI) | 1083982078 |
| PAC ID by PECOS | 2769601251 |
| Professional Enrollment ID | I20140916000605 |
| Full Name | Kelly M Supataraporn |
| Organization Legal Name | PAXXON HEALTHCARE SERVICES LLC |
| Address |
8351 Sheridan Rd Kenosha WI 53143-6339 |
| Phone Number | 2624567408 |
| Gender | F |
| Graduation Year | 2010 |
| Primary Specialty | OCCUPATIONAL THERAPY |
| Group Practice PAC ID | 8325959554 |
| Number of Group Practice Members | 105 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 8351 Sheridan Rd, Kenosha, WI 53143-6339 | 2624567408 | PAXXON HEALTHCARE SERVICES LLC |
| 9651 Prairie Ridge Blvd, Pleasant Prairie, WI 53158-1928 | 2624557408 | PAXXON HEALTHCARE SERVICES LLC |
| 1111 E Capitol Dr, Shorewood, WI 53211-1810 | 4143128146 | PAXXON HEALTHCARE SERVICES LLC |
| Organization Legal Name | PAXXON HEALTHCARE SERVICES LLC |
| Physicians | 136 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sara C Rinas | Physical Therapy | Paxxon Healthcare Services LLC | 16 W301, Burr Ridge, IL 60527-6290 |
| Kenneth J Spychalski | Physical Therapy | Paxxon Healthcare Services LLC | 1035 Fulton Greer Rd, Franklin, TN 37064-2296 |
| Ross Enyart | Physical Therapy | Paxxon Healthcare Services LLC | 545 Belmont Ln, Carol Stream, IL 60188-2467 |
| Juan Carlo C Calvadores | Occupational Therapy | Paxxon Healthcare Services LLC | 2200 Golf Rd, Glenview, IL 60025-4903 |
| Sumithra Rajendran | Physical Therapy | Paxxon Healthcare Services LLC | 9651 Prairie Ridge Blvd, Pleasant Prairie, WI 53158-1928 |
| Kimberly A Wing | Physical Therapy | Paxxon Healthcare Services LLC | 8100 Geddes Rd, Phc Vibrant Life Senior Living, Ypsilanti, MI 48198-9569 |
| Chloe Morgan | Speech Language Pathologist | Paxxon Healthcare Services LLC | C/o Belmont Village At Johns Creek, Suwanee, GA 30024-6048 |
| Jeneane L Breunig | Speech Language Pathologist | Paxxon Healthcare Services LLC | 1820 S 75th St, West Allis, WI 53214-5709 |
| Stacy M Kosha | Occupational Therapy | Paxxon Healthcare Services LLC | 611 W County Line Rd S, Hearth At Sycamore Village, Ft Wayne, IN 46814-7592 |
| Carla J Correa | Occupational Therapy | Paxxon Healthcare Services LLC | 8351 Sheridan Rd, Kenosha, WI 53143-6339 |
| Street Address |
8351 SHERIDAN RD |
| City | KENOSHA |
| State | WI |
| Zip | 53143-6339 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carla J Correa | Occupational Therapy | Paxxon Healthcare Services LLC | 8351 Sheridan Rd, Kenosha, WI 53143-6339 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Bower | Optometry | Robert B. Bower, O.d., S.c. | 2301 75th St, Kenosha, WI 53143-1403 |
| Eugene John Eldridge | Ophthalmology | 1400 75th St, Kenosha, WI 53143-1544 | |
| Daniel Dashner | Clinical Social Worker | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Jennifer L Evancy | Clinical Social Worker | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Kemba M Banyard | Nurse Practitioner | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Tierney Voit | Clinical Social Worker | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Jonathan T Grapengieser | Psychologist, Clinical | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Leah J Featherstone | Psychologist, Clinical | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Renee M Andreoli | Nurse Practitioner | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Amy Macdonald Wojcik | Clinical Social Worker | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Find all physicians in zip 53143 | |||
| City | KENOSHA |
| Zip Code | 53143 |
| Specialty | OCCUPATIONAL THERAPY |
| City + Specialty | KENOSHA + OCCUPATIONAL THERAPY |
Please comment or provide details below to improve the information on Kelly M Supataraporn.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.