Individual
WAYNE DAVID KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1883 HICKS RD, SUITE A, ROLLING MEADOWS, IL 60008-1254
(847) 359-9432
Mailing address
1883 HICKS RD, SUITE A, ROLLING MEADOWS, IL 60008-1254
(847) 359-9432
(888) 687-1245
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
036078457
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036078457
STATE OF IL LICENSE
IL
Enumeration date
10/10/2006
Last updated
02/10/2018
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