Kelly Boris

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

719 N Marion St
Oak Park, IL 60302-1530

Phone

(312) 401-0975

NPI assigned

Jul 27, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• M Street Pediatric Therapy Corp

  • Pediatric Physical Therapist
  • Oak Park, IL
  • NPI 1588193593

  Speech-Language Pathologist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1003597675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 N CLEAVER ST APT 2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422460",
            "telephone_number": "630-303-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 N MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021530",
            "telephone_number": "312-401-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORIS",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betzaida Bonilla-Davila
• Addison Grace Boore
• Karen Bopp, MA, LCPC
• Kaylee Borer, DPT
• Jonna Borgdorff, PT
• Christina Borjas, RD
• Ashley Erin Boumgarden
• Michael James Bowker, OD
• Kerbi Lorrin Bowman, LCPC
• Jessica Alana Boy, MT-BC

• All providers in Oak Park, IL
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.