Individual
DR. KELLY WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
101 FULTON ST, WILMINGTON, IL 60481-1694
(815) 476-6755
Mailing address
41 MAYFLOWER DR, BATAVIA, IL 60510-2808
(630) 338-6439
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019033776
IL
1223G0001X
General Practice Dentistry
D11510
OR
Other
Enumeration date
08/13/2021
Last updated
10/09/2022
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