Provider Demographics
NPI:1407075062
Name:CHOP, KELLI (OTR)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:CHOP
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12304 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2531
Mailing Address - Country:US
Mailing Address - Phone:615-896-6400
Mailing Address - Fax:
Practice Address - Street 1:6500 GREELEY AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66104-2647
Practice Address - Country:US
Practice Address - Phone:913-334-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1700846225X00000X
MO2009028049225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist