Individual
MR. MICHAEL EDWARD KELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N, L.C.S.W.
Contact information
Practice address
6808 N WAYNE AVE, CHICAGO, IL 60626-3718
(773) 537-3615
(773) 537-3466
Mailing address
2737 W LUNT AVE, CHICAGO, IL 60645-3005
(773) 973-2126
(773) 537-3466
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149.011523
IL
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
041.173569
IL
Other
Enumeration date
03/11/2011
Last updated
03/11/2011
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