Individual ProviderKelsey StallterSocial WorkerBehavioral Health & Social Service ProvidersPractice Address443 W Wrightwood Ave Apt 607, Chicago, IL 60614-2963(630) 328-9674PECOS EnrollmentBased on the most recent information from CMS, provider Kelsey Stallter does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1114500840Provider TypeIndividualFull NameStallter, KelseyGenderFemaleSole ProprietorNoEnumeration Date4/30/2021Last Updated4/30/2021Contact InformationPractice LocationPractice Address443 W Wrightwood Ave Apt 607, Chicago, IL 60614-2963Phone(630) 328-9674FaxUnlisted FaxMailing LocationMailing Address443 W Wrightwood Ave Apt 607, Chicago, IL 60614-2963Phone(630) 328-9674FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149.023011Illinois