Active NPI
Kelly Lynn Stiles, LMT
- Specialist
- Streator, IL
National Provider Identifier
1851552012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 227.008317
- Practice address
- 1410 E Main St
Streator, IL 61364-3147 - Phone
- (815) 830-6918
- NPI assigned
- Jun 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 227.008317 | IL | Primary |
Addresses
Primary practice location
1410 E Main St
Streator, IL 61364-3147
Mailing address
4108 Main St
Streator, IL 61364-9667
Phone (815) 830-6918
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 |
|---|---|---|---|
| 227.008317 | IL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213920000000",
"number": "1851552012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4108 MAIN ST",
"city": "STREATOR",
"state": "IL",
"postal_code": "613649667",
"telephone_number": "815-830-6918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1410 E MAIN ST",
"city": "STREATOR",
"state": "IL",
"postal_code": "613643147",
"telephone_number": "815-830-6918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILES",
"first_name": "KELLY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-20",
"last_updated": "2008-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": "227.008317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Streator, IL
- St. Margaret'S Health-Peru (IVCH Medical Group / Streator Medical Clinic)
- St. Mary'S Hospital (St. Mary's Vascular and Thoracic Surgery)
- St. Mary'S Hospital
- St. Mary'S Hospital Streator Hospital Sisters of the 3Rd Order St Fran
- St. Marys Hospital (St. Mary's Prairie Cardiology)
- Kimberly Stoffle
- Streator Chidlrens Clinic
- Streator Elem School Dist 44
- Streator Emergency Medical Services Inc
- Streator Hearing Care LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.