Individual
MRS. KELLY SUE LICARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
800 W CENTRAL RD, NORTHWEST COMMUNITY HOSPITAL, ARLINGTON HEIGHTS, IL 60005-2349
(847) 618-3040
Mailing address
1886 KEYSTONE PL, SCHAUMBURG, IL 60193-3534
(773) 398-2686
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
IL
Other
Enumeration date
08/05/2006
Last updated
09/14/2007
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