NPI
Kellie Marie Gladys
NPI 1194454173
Read from the NPPES registry on October 24, 2026.
Facts
- Status
- Active
- Credential
- OD
- Type
- Individual
- Enumeration date
- 2022-06-06
- Last updated
- 2023-09-12
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Specialties
Licenses
- License GA
- OPT003413
Location
- Practice location
- 207 Hamilton Road
- City
- Bloomington IL
- Postal code
- 61704
- Phone
- (309) 827-4090
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Optometrists in Bloomington, IL. 29 with this primary taxonomy in the public file.
Other NPIs in Bloomington, IL. 2,435 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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