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Individual

STEPHEN M KELANIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., F.A.C.S.

Contact information

Practice address
2040 OGDEN AVE STE 401, AURORA, IL 60504-7208
(630) 978-6895
(630) 375-2905
Mailing address
2040 OGDEN AVE STE 401, AURORA, IL 60504-7208
(630) 978-6895
(630) 375-2905

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036099831
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040017903
RAIL ROAD MEDICARE
IL
01
4506907
BLUE CROSS BLUE SHIELD
IL
05
H08942
IL
Enumeration date
07/19/2006
Last updated
11/05/2024
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