Kelly Marie Gamble

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

05600877 Issued in IL

Practice address

5201 Walnut Avenue
Ste 4
Downers Grove, IL 60515-4025

Phone

(630) 964-4707

Fax

(630) 964-4797

NPI assigned

Aug 7, 2007

Sex

Female

Sole proprietor

Yes

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

State licenses

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.

• Pediatric Rehabilitation Services

  • Rehabilitation Clinic/Center
  • Downers Grove, IL
  • NPI 1639221682
  NPD (past)

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1396936043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 HEATHER GLEN DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519719",
            "telephone_number": "815-463-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WALNUT AVENUE",
            "address_2": "STE 4",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154025",
            "telephone_number": "630-964-4707",
            "fax_number": "630-964-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "05600877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zollie Benson Gadson III, PHARMD
• Tara Gagner, ANP
• Kerry Galarza, OTR L
• Carlo Gallo, DC
• Joao Felipe De Brito Galvao, M.V., MS, DACVIM
• Jennifer Gamblin, M.S., OTR-L
• Swati Gandhi, O.D.
• Jamise A Gant, APRN
• Riya Garapati
• Nubia Carolina Garcia Martinez, DDS

• Pediatric Occupational Therapist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Pediatric Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.