Individual
KELLY A HOLTKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
650 S RANDALL RD, ALGONQUIN, IL 60102-5944
(815) 398-9491
(815) 381-7498
Mailing address
BOX 78534, MILWAUKEE, IL 53278-8534
(815) 398-9491
(815) 381-7498
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036106560
IL
207XS0106X
Orthopaedic Hand Surgery Physician
036106560
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106560
—
IL
Enumeration date
11/07/2005
Last updated
02/05/2020
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