Individual
DR. KELLY JEAN VALLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-5298
(888) 824-2176
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
2016023747
MO
208600000X
Surgery Physician
036144868
IL
208600000X
Surgery Physician
Primary
2016023747
MO
2086S0102X
Surgical Critical Care Physician
036144868
IL
2086S0102X
Surgical Critical Care Physician
2016023747
MO
2086S0102X
Surgical Critical Care Physician
288139
MA
2086S0127X
Trauma Surgery Physician
036144868
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200029344
—
MO
Enumeration date
06/01/2011
Last updated
01/22/2026
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