Individual
MRS. LESLIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2850 W 95TH ST, EVERGREEN PARK, IL 60805-2735
(708) 423-2662
(708) 398-6926
Mailing address
2850 W 95TH ST, EVERGREEN PARK, IL 60805-2735
(708) 423-2662
(708) 398-6926
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209012373
IL
Other
Enumeration date
03/06/2015
Last updated
10/15/2015
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