Individual ProviderKelly PhelanBehavior AnalystBehavioral Health & Social Service ProvidersPractice Address11914 S Route 59 Unit 124, Plainfield, IL 60585(815) 469-1500PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Phelan 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 2 days ago.Profile DetailsProvider ID1700385960Provider TypeIndividualFull NamePhelan, KellyCredentialMA, BCBAGenderFemaleSole ProprietorNoEnumeration Date2/2/2018Last Updated8/27/2020Contact InformationPractice LocationPractice Address11914 S Route 59 Unit 124, Plainfield, IL 60585Phone(815) 469-1500FaxUnlisted FaxMailing LocationMailing Address11914 S Route 59 Unit 124, Plainfield, IL 60585-5110PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode103K00000XPrimaryDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicense1-20-44141Code106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseRBT-16-26776Arizona