Individual
ANGEL MICHELLE KELLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1836 N HUMBOLDT BLVD APT 2A, CHICAGO, IL 60647-5033
(586) 690-5133
Mailing address
137 N OAK PARK AVE STE 327, OAK PARK, IL 60301-1375
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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