Provider Demographics
NPI:1265057095
Name:MEEHLEIB, KELLY LYNN (BS)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:LYNN
Last Name:MEEHLEIB
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9752 BENNINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-2333
Mailing Address - Country:US
Mailing Address - Phone:224-623-1101
Mailing Address - Fax:
Practice Address - Street 1:9752 BENNINGTON DR
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-2333
Practice Address - Country:US
Practice Address - Phone:224-623-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist