Individual
DESTINY KELLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5841 S MARYLAND AVE STE MC6098, CHICAGO, IL 60637-1448
(855) 702-8222
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-174599
IL
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
Primary
036.174599
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2022
Last updated
02/19/2026
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