Individual
KELLEY THUY-LY PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
259 E ERIE ST STE 1600, CHICAGO, IL 60611-3111
(312) 695-6868
(312) 695-2729
Mailing address
259 E ERIE ST STE 1600, CHICAGO, IL 60611-3111
(312) 695-6868
(312) 695-2729
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071010616
CA
103TC0700X
Clinical Psychologist
Primary
071010616
IL
Other
Enumeration date
12/22/2017
Last updated
11/14/2022
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