Provider Demographics
NPI:1821703596
Name:LOWE, KELSEY B (MA)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:B
Last Name:LOWE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ELM CREEK DR APT 214
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5289
Mailing Address - Country:US
Mailing Address - Phone:630-520-1861
Mailing Address - Fax:
Practice Address - Street 1:3100 W HIGGINS RD STE 175
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7244
Practice Address - Country:US
Practice Address - Phone:847-469-9836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program