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Individual

JOAN KELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
309 RIVERS EDGE DR, MINOOKA, IL 60447-9397
(815) 735-1408
Mailing address
309 RIVERS EDGE DR, MINOOKA, IL 60447-9397
(815) 735-1408

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209012858
IL

Other

Enumeration date
07/09/2015
Last updated
07/09/2015
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