Provider Demographics
NPI:1366450991
Name:KELMAN-WEBER, KAREN A (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:A
Last Name:KELMAN-WEBER
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2662 MCFARLAND RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6806
Mailing Address - Country:US
Mailing Address - Phone:815-226-8780
Mailing Address - Fax:815-227-1744
Practice Address - Street 1:2662 MCFARLAND RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6806
Practice Address - Country:US
Practice Address - Phone:815-226-8780
Practice Address - Fax:815-227-1744
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-000452225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL056-000452OtherSTATE LICENSE
K07247Medicare ID - Type Unspecified
P02907Medicare UPIN