Individual
DR. KELLEY ANN MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
9119 S EXCHANGE AVE, CHICAGO, IL 60617-4225
(773) 768-5000
(773) 768-7706
Mailing address
9119 S EXCHANGE AVE, CHICAGO, IL 60617-4225
(773) 768-5000
(773) 768-7706
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026778
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019026778
—
IL
Enumeration date
07/07/2006
Last updated
09/20/2011
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