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Individual
DR. DEREK JOSEPH KELLY
Active
Individual
DR. DEREK JOSEPH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036063365
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031600421
BLUE CROSS
IL
Enumeration date
03/13/2007
Last updated
01/29/2026
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