Individual
MRS. KELLY A OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1247 RICKERT DRIVE, #200, NAPERVILLE, IL 60540
(630) 420-2323
(630) 420-2323
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
85-002264
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085-002264
PHYSICIAN ASSISTANTS LICE
IL
Enumeration date
03/19/2007
Last updated
07/24/2023
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