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Individual

KELLI MARIE KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
24600 W 127TH ST, STE B325, PLAINFIELD, IL 60585-9502
(815) 731-9100
(815) 731-9110
Mailing address
24600 W. 127TH ST, STE B325, PLAINFIELD, IL 60585-9502
(815) 731-9100
(815) 731-9110

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
36117064
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036117064 2
IL
01
2220936
BCBS
IL
Enumeration date
03/27/2007
Last updated
03/10/2009
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