Individual
KATHLEEN M KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6438 OLD HUNTERS RUN, ROCKFORD, IL 61114-7812
(815) 298-1069
Mailing address
6438 OLD HUNTERS RUN, ROCKFORD, IL 61114-7812
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-079899
IL
Other
Enumeration date
01/26/2026
Last updated
02/19/2026
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