Individual
MS. MICHAEL ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D., L.D.N.
Contact information
Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 756-1521
Mailing address
205 W SOUTH ST, DWIGHT, IL 60420-1238
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005938
IL
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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