Individual
MRS. STEPHANIE C. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(773) 665-3000
Mailing address
185 PENNY AVE, EAST DUNDEE, IL 60118-1454
(847) 836-7015
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041258087
IL
Other
Enumeration date
08/11/2006
Last updated
05/16/2012
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