Individual
KELLY ANN PARISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-5845
(847) 772-0046
Mailing address
30 PARKVIEW CT, CRYSTAL LAKE, IL 60012-3540
(847) 772-0046
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178012952
IL
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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