Organization
CPC SURGICAL SUITE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES M KELLY MD (DOCTOR)
(815) 929-1520
Entity
Organization
Contact information
Practice address
555 W COURT ST STE 100, KANKAKEE, IL 60901-3673
(815) 929-1520
(815) 614-3029
Mailing address
555 W COURT ST STE 100, KANKAKEE, IL 60901-3673
(815) 929-1520
(815) 614-3029
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
03/16/2020
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