Individual
KELSEY KENNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
225 E CHICAGO AVE # 130, CHICAGO, IL 60611-2991
(312) 322-7508
Mailing address
225 E CHICAGO AVE # 130, CHICAGO, IL 60611-2991
(312) 227-5088
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150102777
IL
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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