Individual
MRS. KELLY DANAE VOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
2614 N WILTON AVE, #1, CHICAGO, IL 60614-7999
(620) 200-1086
Mailing address
2614 N WILTON AVE, #1, CHICAGO, IL 60614-7999
(620) 200-1086
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209010428
IL
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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