Individual
MEGHAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGACNP-BC
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(888) 352-7874
Mailing address
2237 N FREMONT ST APT 3R, CHICAGO, IL 60614-3665
(703) 655-9334
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209.016987
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041.458330
REGISTERED NURSING LICENSE NUMBER
IL
01
—
209.016987
APN LICENSE NUMBER
IL
Enumeration date
12/14/2017
Last updated
12/14/2017
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