Devamon Kelly

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.010281 Issued in IL

Practice address

1801 S Highland Ave Ste L10
Lombard, IL 60148-4932

Phone

(630) 873-8863

NPI assigned

Jan 15, 2025

Last updated

Jan 15, 2025By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1669283081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 CIRCLE AVE APT 1",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S HIGHLAND AVE STE L10",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484932",
            "telephone_number": "630-873-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DEVAMON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.010281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L Keating, DC, ND
• Joseph Kedzuch
• Kristine Kelch
• Molly Claire Keljalic
• Meredith Slovick Keller, RDH
• Richard A Kelly, PSYD
• Eftehia Kempski, RN
• Emily Brittingham Kerbuski, DPT, GCS
• Benjamin Scott Kester, M.D.
• Tahseen Anjum Khaleel, MD

• Physical Therapy Assistant in Lombard, IL
• Providers in Lombard, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.