Search › Illinois › 225X00000X
Kelly Supataraporn
NPI 1083982078 · on the registry since 2011
Practice
- Address
- 388 Twin Creeks Dr
Bolingbrook, IL 60440 - Phone
- (630) 453-0134
Registry record
- Primary taxonomy
- 225X00000X
225X00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2011-12-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois