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RYAN KELLOG
NPI 1114556719
Counselor - Mental Health in East Peoria, IL

Active since April 06, 2020
111 W WASHINGTON ST STE 203, EAST PEORIA, IL 61611(309) 671-8060 Get Directions Write a Review

NPPES record last updated: April 6, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ryan Kellog NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RYAN KELLOG (NPI 1114556719) is an individual mental health provider in East Peoria, Illinois and active in the NPI registry since April 2020.

NPPES Registry Identity

NPI1114556719
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameRYAN KELLOG
Location Address111 W WASHINGTON ST STE 203East Peoria, IL 61611-2532
Mailing Address111 W Washington St Ste 203East Peoria, IL 61611-2532
Phone(309) 671-8060
Sole ProprietorNo
Enumeration DateApril 6, 2020
NPPES CertifiedApril 6, 2020
✔ NPI 1114556719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
111 W WASHINGTON ST STE 203, East Peoria, IL 61611
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ryan Kellog's NPI number?

The NPI number for Ryan Kellog is 1114556719. It was assigned to this individual provider in the NPPES registry on April 6, 2020.

Where is Ryan Kellog located?

Ryan Kellog practices at 111 W Washington St Ste 203, East Peoria, IL 61611. The listed phone number is (309) 671-8060.

What is Ryan Kellog's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Ryan Kellog was last updated on April 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.