Individual
KELLY SHI THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 318-2710
Mailing address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-2210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
77739
MN
Other
Enumeration date
04/19/2022
Last updated
04/09/2026
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