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Contact Information

KELLY GUNDERSON
3001 GREEN BAY RD
NORTH CHICAGO, IL60064-3048
 Phone: 224-610-4154
 Fax: 224-610-3706
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Kinesiotherapist

226300000X
 

Massage Therapist

225700000X
Indicates primary specialty

NPI Profile & details for KELLY GUNDERSON · (Female)

NPI # 1750682720
Status Active
Credentials
Entity Individual
Enumeration date 11/08/2010
Last updated 09/10/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 4393-046
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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