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Individual
CAROLYN KELLY
Active
Individual
CAROLYN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
135000752
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016.005524
IL
213ES0131X
Foot Surgery Podiatrist
016005524
IL
Other
Enumeration date
07/06/2011
Last updated
08/12/2019
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