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Individual

MRS. KELLY STONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1752 WINDSOR RD STE 203, LOVES PARK, IL 61111-4276
(815) 986-1113
Mailing address
1752 WINDSOR RD STE 203, LOVES PARK, IL 61111-4276
(815) 986-1113

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1104464767
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209.020616
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277.001677
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
277.001677
LICENSE NUMBER
IL
Enumeration date
12/13/2019
Last updated
02/07/2023
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