Provider Demographics
NPI:1235738956
Name:CURL, KELLY (MS)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:CURL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-3032
Mailing Address - Country:US
Mailing Address - Phone:217-347-7179
Mailing Address - Fax:
Practice Address - Street 1:1200 N 4TH ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-3032
Practice Address - Country:US
Practice Address - Phone:127-347-7179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL370912882Medicaid