Kelly Chernik, OTR

Individual provider Active NPI Occupational Therapist · Prairie Du Sac, WI

NPI 1588222004 · NPPES record last updated May 30, 2019

Key facts

NPI
1588222004
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
6432-26 (WI)
Practice address
90 Oak St
Prairie Du Sac, WI 53578-1554
Phone
(608) 643-7263
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

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
6432-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Therapy and Development Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6432-26 WI Yes

Addresses

Primary practice location

90 Oak St
Prairie Du Sac, WI 53578-1554

Mailing address

90 Oak St
Prairie Du Sac, WI 53578-1554
Phone (608) 643-7263

Other providers in Prairie Du Sac, WI

All providers in Prairie Du Sac, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.