Provider Demographics
NPI:1053728204
Name:BABEL, KERRY
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:BABEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3602
Mailing Address - Country:US
Mailing Address - Phone:630-495-2497
Mailing Address - Fax:
Practice Address - Street 1:720 E MADISON ST
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3602
Practice Address - Country:US
Practice Address - Phone:630-936-8622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program