Individual
KATHERINE KENNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
225 E CHICAGO AVE, MAILSTOP 69, CHICAGO, IL 60611-2991
(312) 227-4000
Mailing address
1016 S SCOVILLE AVE, OAK PARK, IL 60304-2128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209010738
IL
Other
Enumeration date
07/09/2014
Last updated
04/21/2020
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