Provider Demographics
NPI:1043549785
Name:ROSNER, KELLY C (DT)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:C
Last Name:ROSNER
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20331 S GREEN MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8731
Mailing Address - Country:US
Mailing Address - Phone:847-347-3812
Mailing Address - Fax:
Practice Address - Street 1:20331 S GREEN MEADOW LN
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-8731
Practice Address - Country:US
Practice Address - Phone:847-347-3812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist