Individual
KELLY MARIE FENING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1775 DEMPSTER ST, MAILBOX #48, PARK RIDGE, IL 60068
(847) 723-2210
Mailing address
4300 LONDONDERRY RD, HARRISBURG, PA 17109-5317
(717) 657-7484
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1295364974
PA
208C00000X
Colon & Rectal Surgery Physician
Primary
OT020006
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2020
Last updated
04/11/2025
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