Individual
MRS. KELLY MARIE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.P.
Contact information
Practice address
345 E SUPERIOR ST, ROOM 1764, CHICAGO, IL 60611-2654
(312) 238-2810
(312) 238-1932
Mailing address
345 E SUPERIOR ST, ROOM 1764, CHICAGO, IL 60611-2654
(312) 238-2810
(312) 238-1932
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
211-000190
IL
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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