Kelsey Jane Fernandez, L. AC.- NMD

Individual provider Active NPI Acupuncturist · River Forest, IL

NPI 1053530998 · NPPES record last updated Sep 20, 2019

Key facts

NPI
1053530998
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
198-000448 (IL)
Practice address
7627 Lake St Ste 201
River Forest, IL 60305-1878
Phone
(708) 689-0473
Fax
(708) 395-2641
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
198-000448ILMDAcupuncturist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198-000448 IL Yes

Addresses

Primary practice location

7627 Lake St Ste 201
River Forest, IL 60305-1878

Mailing address

7627 Lake St Ste 201
River Forest, IL 60305-1878
Phone (708) 769-9929

Other providers in River Forest, IL

All providers in River Forest, IL · Acupuncturist in Illinois

Sources for this page

Verify at the official NPI Registry.