Individual
KELLY MARIE HARTNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2000
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(847) 570-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085011099
IL
Other
Enumeration date
02/03/2025
Last updated
02/07/2025
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