Individual
DR. KELLY BRUNGARDT STEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9701 KNOX AVE, STE 102, SKOKIE, IL 60076-1256
(847) 676-1112
Mailing address
9701 KNOX AVE, STE 102, SKOKIE, IL 60076-1256
(847) 676-1112
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036126038
IL
207R00000X
Internal Medicine Physician
D0064374
MD
Other
Enumeration date
02/05/2007
Last updated
04/20/2011
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