Individual
MRS. ASHLEE CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16505 106TH CT, ORLAND PARK, IL 60467-4545
(708) 364-1550
(708) 364-1468
Mailing address
9830 RIDGELAND AVE, CHICAGO RIDGE, IL 60415-2667
(708) 636-8747
(708) 636-5854
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209010813
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209010813
STATE OF ILLINOIS
IL
Enumeration date
10/16/2013
Last updated
10/16/2013
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