Individual
CODY KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
676 N SAINT CLAIR ST STE 14-044, CHICAGO, IL 60611-2927
(312) 695-1800
(312) 695-1394
Mailing address
676 N SAINT CLAIR ST STE 14-044, CHICAGO, IL 60611-2927
(312) 695-1800
(312) 695-1394
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085011522
IL
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/18/2024
Last updated
02/06/2026
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