Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimyetta Ellis

Individual provider Occupational Therapy Assistant · NPI 1538630181

Kimyetta Ellis is an Occupational Therapy Assistant in Homewood, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2018
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Practice location Address checks out

18321 California Ave
Homewood, IL 60430-2812
Phone: (708) 261-6506
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 411427 (IL)

Record details

NPI number1538630181
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 7, 2018
Last updated in NPPESDecember 7, 2018

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