Individual
DR. JOHN THOMAS KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
175 BLOSSOM ST UNIT 1407, BOSTON, MA 02114-2629
(215) 527-4684
Mailing address
175 BLOSSOM ST UNIT 1407, BOSTON, MA 02114-2629
(215) 527-4684
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036-077958
IL
Other
Enumeration date
10/31/2009
Last updated
03/13/2023
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