Organization
MARY L. KELLY, D.O., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LOUISE KELLY D.O. (PRESIDENT)
(708) 848-0040
Entity
Organization
Contact information
Practice address
1125 WESTGATE ST, OAK PARK, IL 60301-1007
(708) 848-0040
(708) 848-2931
Mailing address
1125 WESTGATE ST, OAK PARK, IL 60301-1007
(708) 848-0040
(708) 848-2931
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036077560
IL
Other
Enumeration date
12/09/2010
Last updated
12/18/2013
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