Active NPI
Kelly M Phillips, DVM
- Veterinarian
- Algonquin, IL
National Provider Identifier
1104118355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 090010516
- Practice address
- 1808 S Randall Rd
Algonquin, IL 60102-5925 - Phone
- (847) 854-3351
- NPI assigned
- May 6, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 090010516 | IL | Primary |
Addresses
Primary practice location
1808 S Randall Rd
Algonquin, IL 60102-5925
Mailing address
1808 S Randall Rd
Algonquin, IL 60102-5925
Phone (847) 854-3351
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090010516 | IL | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343088000000",
"number": "1104118355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 S RANDALL RD",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601025925",
"telephone_number": "847-854-3351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 S RANDALL RD",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601025925",
"telephone_number": "847-854-3351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "KELLY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DVM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-06",
"last_updated": "2012-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "IL",
"license": "090010516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Algonquin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.