Individual
PAUL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7921 S TRUMBULL AVE, CHICAGO, IL 60652-1454
(708) 728-5460
Mailing address
7921 S TRUMBULL AVE, CHICAGO, IL 60652-1454
(708) 728-5460
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178020309
IL
103TB0200X
Cognitive & Behavioral Psychologist
KELL-GLU4KJ
IL
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
11/01/2024
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