Individual
CARLOS KELLENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4250 N MARINE DR, APT 502, CHICAGO, IL 60613-1744
(773) 935-0199
Mailing address
4250 N MARINE DR, APT 502, CHICAGO, IL 60613-1744
(773) 935-0199
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-057301
IL
Other
Enumeration date
04/16/2007
Last updated
01/08/2019
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