Individual
KEVIN V KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2040 OGDEN AVE, SUITE 300, AURORA, IL 60504-7206
(630) 978-6770
(630) 978-6773
Mailing address
1256 WATERFORD DRIVE, SUITE 230, AURORA, IL 60504
(630) 499-2404
(630) 499-2399
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036129046
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200036820A
—
OK
Enumeration date
04/13/2006
Last updated
07/10/2017
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