IndividualActive
Kellie Ivie
NPI 1942814769 · Speech-Language Pathologist · Edwards, IL
Provider details
- NPI number
- 1942814769
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 146.016263 (IL)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Speech, Language and Hearing Service Providers
Practice location
5601 Brookmere St
Edwards, IL 61528-9408
Phone: (309) 363-7594
Fax: (309) 966-3621
Approximate (ZIP-level) locationGet directions
Mailing address
5601 Brookmere St
Edwards, IL 61528-9408
Registry dates
- Enumerated
- 2020-08-31
- Last updated
- 2022-02-10
- Certified
- 2022-02-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.