Individual
DR. KELLEY KATHLEEN STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 W SUPERIOR ST, CHICAGO, IL 60622-5646
(312) 666-3494
Mailing address
1126 WISCONSIN AVE, OAK PARK, IL 60304-1820
(312) 217-1662
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036115572
IL
Other
Enumeration date
06/29/2006
Last updated
08/09/2021
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