Individual
KIMBERLY KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
109 E 47TH ST, CHICAGO, IL 60653-3806
(773) 759-3516
Mailing address
9140 S CREGIER AVE, CHICAGO, IL 60617-3537
(773) 759-3516
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
041334849
IL
Other
Enumeration date
02/27/2021
Last updated
02/27/2021
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