Individual
COLLEEN E KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
319 E MADISON ST FL 2, SPRINGFIELD, IL 62701-1035
(217) 545-8000
(217) 545-9537
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003555
IL
Other
Enumeration date
09/04/2009
Last updated
12/20/2022
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