Individual
KELLEY MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5721 S MARYLAND AVE, CHICAGO, IL 60637-1425
(773) 702-6565
Mailing address
1524 LAWRENCE AVE, LOCKPORT, IL 60441-4203
(815) 735-7137
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
041424656
IL
363LN0005X
Critical Care Neonatal Nurse Practitioner
209.024433
IL
Other
Enumeration date
11/26/2021
Last updated
09/30/2024
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