Provider Demographics
NPI:1316220387
Name:BOND, KELLY S (DC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:S
Last Name:BOND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 PHELPS AVE STE 601
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-3101
Mailing Address - Country:US
Mailing Address - Phone:815-229-5568
Mailing Address - Fax:815-860-1674
Practice Address - Street 1:431 PHELPS AVE STE 601
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-3101
Practice Address - Country:US
Practice Address - Phone:815-229-5568
Practice Address - Fax:815-860-1674
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012782111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor